An 11 year-old girl with a history of chronic, intermittent headaches suddenly collapsed while on a school trip.
An initial CT of the brain revealed an extensive subarachnoid hemorrhage (SAH), with mild hydrocephalous. She underwent temporary endoventricular drainage and a cerebral angiogram (Figure 1) which demonstrated a small “blister” aneurysm or dissection of the right Internal Carotid Artery(ICA) terminus.
Based on her young age and wide-neck morphology, surgical exploration and microsurgical clipping of this aneurysm was successfully performed by pediatric neurosurgeon John A. Grant, M.D., to prevent life-threatening recurrent hemorrhage. Angiograms immediately following clipping and at 6 months (Figure 2) confirms complete exclusion of the aneurysm.
She has made a full recovery and has returned to join the 6
th
grade and all of her activities.