Vertebral artery dissection aneurysm in a pediatric patient: A rare case with unusual clinical manifestations, diagnostic, and management challenges.

Vertebral artery aneurysm is a rare condition with diverse clinical manifestations in pediatric patients. We present the case of a 12-year-old male who presented with diplopia, vomiting, ataxia, and severe headache. Diagnostic evaluation revealed an extracranial vertebral artery dissection with an associated aneurysm at the C3-C4 level. Despite the absence of recurrent ischemic strokes, the aneurysm posed challenges in differentiating the symptoms from other inflammatory demyelinating disorders, particularly internuclear ophthalmoplegia. Diagnosis relied on a thorough history, physical examination, and imaging studies. Magnetic resonance imaging with magnetic resonance angiography confirmed the diagnosis and played a crucial role in assessing the size, location, and extent of the aneurysm. Additionally, the imaging findings helped guide treatment decisions and determine the need for anticoagulation therapy. Regular follow-up imaging was initiated to monitor for late complications and evaluate the effectiveness of the management approach. This case highlights the atypical presentation of vertebral artery aneurysm in a pediatric patient, underscoring the importance of clinical suspicion and the role of advanced imaging techniques in facilitating accurate diagnosis and guiding appropriate management. Prompt diagnosis and optimal utilization of imaging modalities are essential in preventing severe morbidity and mortality. Further research is warranted to enhance our understanding of this condition and refine imaging and management protocols in pediatric population.

Experience of King Abdullah Medical City in Placement of Inferior Vena Cava Filter Prior to Bariatric Surgery in Extremely High-Risk Patients for Thromboembolic Events.

INTRODUCTION: Bariatric surgery is used to treat morbid obese patients. Venous thromboembolism (VTE) is considered to be one of the leading causes of postoperative morbidity and mortality. Therefore, inferior vena cava filter (IVCF) is used to minimize the risk of VTE in high-risk patients. MATERIALS AND METHODS: Medical information was collected for the preoperative, operative and postoperative stages for all patients underwent bariatric surgery at KAMC from March 2013 to July 2017. RESULTS: Five cases with IVCF were included in this study. Age ranged from 35 to 66 years old; 4 (80%) were female. Preoperative body mass index ranged from 42 to 64 kg/m2. Postoperative findings were reported. CONCLUSION: IVCF seems to be beneficial for patients undergoing bariatric surgery.