Cerebral aneurysms in children: are we talking about a single pathological entity?

PURPOSE: The objective of this article is to highlight the fact that cerebral aneurysms in children are heterogeneous unlike in the adult population. MATERIAL AND METHODS: This is a retrospective review of 17 children with intracranial aneurysms who were managed at a single institution from 2004 to 2009. RESULTS: The median age was 12 years (range 10 months-17 years). Sixty-five percent of the aneurysms were saccular and 24% were fusiform. There was one infectious and one distal lenticulostriate aneurysm. Patients with saccular aneurysms were predominantly male and presented more commonly with intracranial hemorrhage (91%). The fusiform aneurysms were dissecting in nature or chronic with intramural thrombus and mass effect. The treatment was dependent upon the type and location of the aneurysm. CONCLUSION: Pedriatic aneurysms are a heterogeneous group of intracranial arterial diseases with different etiologies, diverse morphology, and dissimilar clinical manifestations.

[Mycotic aneurysm of the ascending thoracic aorta. Clinico-pathological report of a case]. / Aneurísma micótico de la aorta torácica ascendente. Presentación clíco-patológica de un caso

The case of a six year old girl with a congenital aortic stenosis is presented. A few months before being admitted to the Instituto Nacional de Cardiologia; her clinical manifestations suggested a bacterial endocarditis. The existance of an aneurismatic area in the ascending aorta and the later development of a crisis of angor pectoris, suggested a mycotic aneurism of the ascending aorta as a possible diagnosis; and the dissection or migration of septic material to the aneurism was found, it has a sacular form of 3.5 by 3.8 cm in the ascending aorta. There was also dissection into the left coronary artery at the ostium level. Microscopic study showed areas of recent myocardial necrosis on the free wall of the left ventricle and in the lower part of the interventricular septum. The etiopathogeny, clinical manifesations, radiology, evolution and treatment of mycotic aneurism were considered. The need of an early clinical diagnosis and early medical and surgical treatment is emphasized.

Aortic bacterial endarteritis.

Micotic aneurisms are very rare. They are produced as a consequence of a bacterial infection of the endartery. They are divided into "primary", or those of an unknown septic focus, and "secondary" to bacterial endocarditis, to intravascular in infection or to infection located in a neighboring region. Two cases of the National Institute of Cardiology of Mexico are presented, with "primary" micotic aneurysm, which is the least frequent. One of them was because of bacterial endarteritis located in the thoracic aorta, an extremely rate entity. Due to the frequent rupture of these aneurysm with a very high mortality, emphasis is placed on the convenience of rapid surgical treatment of patients diagnosed.