Treatment of pediatric patient with ruptured intracranial aneurysm--case report.

INTRODUCTION: Despite the contemporary diagnostics of intracranial aneurysms their treatment is still a great challenge. The decision when and if to apply a surgical or endovascular treatment of intracranial aneurysms should be made by a team of medical specialists which consists of a cerebrovascular neurosurgeon, neuro-radiologist and neuro-anesthesiologist. CASE REPORT: We report a case of a patient aged 16 who was admitted because of a sudden intensive headache followed by sickness, vomiting, and loss of consciousness. On admission the patient was conscious but sleepy. Glasgow Coma Scale score was 14 and the World Federation of Neurological Surgeons Scale grade was I. The computed tomography scan showed a massive subarachnoid haemorrhage. The computed tomography angiography and digital subtraction angiography revealed a ruptured saccular aneurysm in the left vertebral artery. An early treatment with the coiling of the lumen of the aneurysm was performed under general anaesthesia. On the tenth day the boy was discharged in good condition and without any neurological deficits. Six months after the intervention the patient was without symptoms and the control digital subtraction angiography showed the complete occlusion of the aneurysm. CONCLUSION: Intracranial aneurysms in children are more common in males and are predominantly localized in the posterior circulation. In addition, they are frequently of greater size and more complex architecture and they are associated with a lower incidence of clinically manifest vasospasm. According to previous experience, endovascular treatment of intracranial aneurysms in paediatric patients has proven to be a safe and efficient method with a small number of complications.

[Current diagnostic trends in radiology].

Since the discovery of X-rays by Wilhelm Conrad Röentgen at the end of the 19th century, diagnostic imaging techniques have been continously improved by technological advances, bringing radiological diagnosis into the very center of modern medicine. Nowadays, it is hard to imagine therapy planning without previous radiological examination. Great advances in the field of computer technology have been accompanied by development of radiological techniques, and today they include not only morphological and anatomical, but also dynamic, functional and molecular imaging. This paper is an overview of new and improved radiological techniques and their implementation.