Endovascular treatment of distal middle cerebral artery dissecting aneurysm with intracerebral hemorrhage in a paediatric patient: a case report and literature review

BackgroundIntracranial arterial aneurysms in the paediatric age group constitute less than 5% of all aneurysms. The most common form is spontaneous dissecting aneurysms (SDAs) (Peron et al. in Acta Neurochir 152(9):1511-1517, 2010; Huang et al. in Surg Neurol 63(5):424-432, 2005; Krishna et al. in Acta Neurochir 147(5):469-476, 2005; Ihn and Jung in J Korean Soc Radiol 65(5):441-445, 2011). It occurs most commonly in the posterior circulation and rarely in the anterior circulation, including the middle cerebral artery (MCA) (Chuang et al. in Asian J Surg 35(1):42-48, 2012; Ozaki et al. in World Neurosurg 113:208-211, 2018). MCA dissecting aneurysm even rarely presents with intracerebral haemorrhage (Ete et al. in J Case Rep 3(2):451-454, 2013; Ahmad in Interdiscip Neurosurg 18:100510, 2019; Bartos et al. in Brain Sci 11(1):29, 2020).Case descriptionA 12 years old non-diabetic, non-hypertensive female presented with distal right MCA (M2-M3 junction) dissecting aneurysm with right parieto-temporal haemorrhage. The patient was well managed with endovascular coil embolization with a good functional outcome.ConclusionEndovascular coil embolization had favourable clinical and angiographic outcomes in distal MCA dissecting aneurysms.