Vargas HA, Buendía LI, Castillo ML, Broc HGG

Language: Spanish
References: 9
Page: 484-486
PDF size: 103.29 Kb.

ABSTRACT

We present the case of a 14 months old girl who initiated on February 16^th of 2006 with loss of consciousness, respiratory failure, pallor of teguments and flaccidity. She was taken to a hospital where she presented respiratory arrest during 3 minutes and was submitted to a surgery to apply a ventriculoperitoneal shunt for hydrocephalus, remaining in the Pediatric Intensive Care Unit. She was referred to our hospital on March 1^st of 2006, with dyspnea, bradichardia, arterial hypotension with modified Glasgow scale of 10 points, bilateral papiledema, subhyaloid hemorrhage, gaze deviated to the left, tongue deviated to the right, global force 2/5, pain sensitivity preserved, hyperreflexia of +++, bilateral Babinski, functional shunt, neck rigidity. Cranial CT with subarachnoid hemorrhage and proximal catheter of shunt system correctly placed. Cranial MRI with a big prepontobulbar irregular image that displace the brainstem, with partial collapse of the aqueduct of Silvio. Angio CT with ca rounded image, well delimited in posterior circulation corresponding to basilar artery. Cerebral angiography with a fusiform image of the basilar artery. She was submitted to a left retromastoid suboccipital craniectomy realizing a gelfoam and muscle cover of the aneurysm. She had a prolonged stay in Pediatric Intensive Care Unit Postsurgical complicated with sepsis and finally she died a few months later.
The review of literature recommend different surgical approaches depending the localization of the aneurysm and the indication is the coverage of the aneurysm.

REFERENCES

1. Schmidek & Swet. Operative Neurosurgical Techniques. Ch 2005; p. 90, 91, 92.

2. Hacker RJ. 500 Cases of intracranial aneurysms in childhood. Neurosurgery 1982; 10: 775.

3. Roberto C. Heros. Pediatric intracranial aneurysms. J Neurosurg Pediatrics 2006; 104: 89-91.

4. Ventureyra ECG. Pediatrics intracranial aneurysms. J Neurosurg Pediatrics 2006; 104: 79-81.

5. Gonzales LF. Skull base approaches to the basilar artery. Neurosurgery Focus 2005; 2: E3.

6. Ralph W. The orbitozigomatic approach. Neurosurgery 2005; (Suppl.)103: Ons 107.

7. Frank PK. Orbitozigomatic approach to basilar apex aneurysms. Neurosurgery Suppl. Ons 177; 2005.

8. Gadelha E. Comparative analysis of anterior petrosectomy and transcabernouse approaches to retrosellar and upper clival basilar artery aneurysms. Neurosurgery 2006; 58(Suppl. 13): Ons 21.

9. Deshmueth V, Spetzler R. Division of neurologic surgery BNI. Phoenix Arizona: Long term clinical and angiographic follow up of unclippable aneurysms. Neurosurgery 2006; 58: 434-42.