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Delayed diagnosis of intracranial aneurysm in pediatrics: the risk of misdiagnosis—a case report

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Abstract

Background

Aneurysms in the pediatric population are uncommon, requiring a high index of suspicion for diagnosis. We report a case of a child with head trauma and delayed diagnosed cerebral aneurysm.

Methods

A 2-year-old girl was brought to the emergency room with seizures. Head imaging showed acute intraventricular hemorrhage, hydrocephalus, and paraclinoid aneurysm of the right internal carotid artery. She had been hospitalized elsewhere 1 month prior for traumatic brain injury after falling to the ground with subarachnoid and intraventricular hemorrhage and good recovery, but without diagnosis of aneurysm.

Results

The child was treated with aneurysm embolization and ventriculoperitoneal shunt, being discharged asymptomatic.

Conclusion

Most primary intraventricular hemorrhage in pediatric population has identifiable etiology. A high rate of clinical suspicion, associated with a low threshold for vascular neuroimaging studies for children with spontaneous or atypical intracranial hemorrhage allow accurate diagnosis, appropriate treatment, and improved outcome.

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Not applicable.

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Authors and Affiliations

  1. Department of Neurosurgery, Hospital de Clínicas, Federal University of Paraná, 8th floor. Street General Carneiro, 181, Curitiba, PR, 80060-900, Brazil

    Zeferino Demartini Jr, Sergio Luiz Sprengel, Simone Cristina Zanine & Luis Alencar Biurrum Borba

  2. Federal University of Parana, Curitiba, PR, Brazil

    Guilherme dos Santos de Alencar

  3. Department of Pediatrics, Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil

    Adriane Cardoso-Demartini

Authors
  1. Zeferino Demartini Jr
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  2. Guilherme dos Santos de Alencar
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  3. Adriane Cardoso-Demartini
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  4. Sergio Luiz Sprengel
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  5. Simone Cristina Zanine
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  6. Luis Alencar Biurrum Borba
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Contributions

Dr. Demartini: study concept and design, manuscript writing; Dr. Alencar: acquisition of data and critical revision; Dr. Cardoso-Demartini: study concept and design, critical revision of the manuscript; Dr. Sprengel: acquisition of data and critical revision; Dr. Zanine: study concept and design, manuscript writing; Dr. Borba: critical revision of the manuscript.

Corresponding author

Correspondence to Zeferino Demartini Jr.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Statement of ethics

This study complies with all institutional guidelines regarding human subjects.

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Informed consent was obtained from the patient’s guardian.

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All authors read and approved the final manuscript and consent for publication.

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Demartini, Z., dos Santos de Alencar, G., Cardoso-Demartini, A. et al. Delayed diagnosis of intracranial aneurysm in pediatrics: the risk of misdiagnosis—a case report. Childs Nerv Syst 37, 3245–3249 (2021). https://doi.org/10.1007/s00381-020-05006-6

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  • DOI: https://doi.org/10.1007/s00381-020-05006-6

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