Minimally invasive management of a traumatic artery aneurysm resulting from shaken baby syndrome

• Published in: Pediatric neurosurgery Vol. 40; no. 3; p. 128
• Main Authors: Levine, Nicholas B, Tanaka, Tomoko, Jones, Blaise V, Crone, Kerry R
• Format: Journal Article
• Language: English
• Published: Switzerland 01-05-2004
• Subjects: Aneurysm, False - etiology; Aneurysm, False - therapy; Embolization, Therapeutic; Humans; Hydrocephalus - etiology; Hydrocephalus - therapy; Infant; Intracranial Aneurysm - etiology; Intracranial Aneurysm - therapy; Neuroendoscopy; Shaken Baby Syndrome - complications; Ventriculostomy
• ISSN: 1016-2291
• DOI: 10.1159/000079855

Based on our review of the literature, we present the first use of coiling in an infant with a traumatic artery aneurysm that resulted from shaken baby syndrome. Computed tomography (CT) scans showed a skull fracture, hemorrhagic subdural collections, multiple parenchymal contusions, and intraventricular and subarachnoid hemorrhages in a 3-week-old infant who presented with lethargy, poor feeding, and seizure. These multiple injuries were consistent with shaken baby syndrome. After closed-head injury medical management, including subdural taps, the baby was discharged home. When increasing seizures and hydrocephalus developed 8 months later, CT angiographic scans showed a pseudoaneurysm of the anterior cerebral artery. We successfully occluded the aneurysm with pushable coils placed via a microcatheter and treated the obstructive hydrocephalus with endoscopic third ventriculostomy. We show that minimally invasive radiological and surgical techniques may be effective in managing the sequelae of trauma in children.