Abstract
We report the case of a 3-week-old neonate who presented with massive subarachnoid
and intraventricular hemorrhage from a ruptured aneurysm of the anterior communicating
artery (ACommA). An attempt on endovascular treatment ended up with therapeutic closure
of the parent artery. However, since further investigation revealed a disastrous supratentorial
cerebral infarction as a result of the hemorrhage, active treatment was terminated
and the neonate died a few days after the initial stroke. To the best of our knowledge
and after reviewing available literature, this is one of only five cases of ACommA
aneurysm in newborns reported to date. Bleeding from an ACommA aneurysm in a neonate
thus represents an extreme clinical rarity. There are no available data comparing
the efficacy and safety of microsurgical versus endovascular treatment in neonates
and small infants, but the latter option may at least reduce the risk associated with
open surgery and further blood loss in this age group.
Keywords
intracranial aneurysm - subarachnoid hemorrhage - newborn