Neurosurgery notes/Paediatrics/Paediatric trauma/Paediatric traumatic aneurysm

Paediatric traumatic aneurysm

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Paediatric trauma
  • Numbers
    • Account for 14-39% of all pediatric aneurysms.
  • Clinical features
    • Children with neurological deterioration after head injury should be suspected to have these lesions and investigated
  • Aetiology
    • Direct trauma (gunshot wounds, stab wounds, or surgical procedures).
    • Indirect trauma by falcine edge, sphenoid ridge, and sharp edge of fractured bone.
  • Patient can present with devastating hemorrhage in 50%.
    • SAH
    • SDH
    • ICH
    • EDH
  • Natural hx
    • Aneurysm can bleed 5 h to 10 years after trauma with a mean of 3 weeks.
      • Present with irritability/unconsciousness or focal signs due to enlargement of aneurysm.
      • Infraclinoid aneurysm can present with diabetes insipidus, cranial nerve deficits, unilateral blindness, recurrent massive epistaxis, and features of carotid-cavernous fistula.
      • Rupture carries mortality of 32-50%.