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Journal of Pediatric Neurology 2012; 10(04): 297-300
DOI: 10.3233/JPN-120579
Case Report
Georg Thieme Verlag KG Stuttgart – New York

Pediatric internal carotid aneurysm as a complication of sphenoid sinusitis

Authors

  • Dimitrios Arkilo

    a   Department of Pediatrics, Floating Hospital for Children at Tufts Medical Center, Boston, MA, USA
    b   Department of Neurology, Tufts Medical Center, Boston, MA, USA

  • Sayyed Nabizadeh

    a   Department of Pediatrics, Floating Hospital for Children at Tufts Medical Center, Boston, MA, USA

  • Adel M. Malek

    c   Department of Neurosurgery, Tufts Medical Center, Boston, MA, USA

  • Ju Tang

    a   Department of Pediatrics, Floating Hospital for Children at Tufts Medical Center, Boston, MA, USA
    b   Department of Neurology, Tufts Medical Center, Boston, MA, USA

  • Kristen Padulsky

    a   Department of Pediatrics, Floating Hospital for Children at Tufts Medical Center, Boston, MA, USA
    b   Department of Neurology, Tufts Medical Center, Boston, MA, USA

  • Uma Khazanie

    a   Department of Pediatrics, Floating Hospital for Children at Tufts Medical Center, Boston, MA, USA

  • Patricia Helm

    a   Department of Pediatrics, Floating Hospital for Children at Tufts Medical Center, Boston, MA, USA

  • Kelly Wills

    a   Department of Pediatrics, Floating Hospital for Children at Tufts Medical Center, Boston, MA, USA

  • Tomo Tarui

    a   Department of Pediatrics, Floating Hospital for Children at Tufts Medical Center, Boston, MA, USA
    b   Department of Neurology, Tufts Medical Center, Boston, MA, USA

Subject Editor:
Further Information

Publication History

20 February 2012

26 April 2012

Publication Date:
30 July 2015 (online)

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Abstract

We report an 8-year-old female who developed left abducens nerve palsy and progressively enlarging left internal carotid aneurysm in the setting of sphenoid sinusitis. Despite conservative management with antibiotics and antiplatelet agent, she developed enlargement of the aneurysm with embolic stroke. For that reason, she underwent occlusion of her left internal carotid artery with coiling, after confirmation of good collateral circulation. The patient tolerated the procedure well, with improvement of her symptoms. To our knowledge, this is the first report documenting good neurological outcome after elective internal carotid occlusion. Due to lack of guidelines, management of aneurysms secondary to infection should be individualized, based on collateral circulation and risk of intervention.

Keywords

Left abducens nerve palsy - carotid aneurysm - sphenoid sinusitis - collateral circulation