We report the case of a large fusiform aneurysm of the anterior cerebral artery in
a 3-month-old girl presenting with generalized seizures and complicated by a cardiorespiratory
arrest needing resuscitation. The native cerebral CT scan revealed a diffuse subarachnoid
hemorrhage (Fischer III grade); CT angiography showed an aneurysm of the distal A1
segment of the anterior cerebral artery (ACA). Successful treatment was achieved through
surgical trapping of the aneurysm and sacrifice of the distal A1 segment. A histological
study of the aneurysmal wall revealed the absence of elastic fibers in an otherwise
fibromuscular media and showed no signs of previous hemorrhage. Intracranial aneurysms
of the ACA are very rare in the early stage of life and their pathogenesis is not
clear. This case is of interest as the location and shape of the aneurysm, the absence
of relevant familial and medical history, and the histopathological findings raise
the hypothesis of a congenital origin. It further describes the value of CT angiography
for studying aneurysms in the very young.
Anterior cerebral artery aneurysm - intracranial aneurysm - newborn - histopathology
- congenital abnormalities
