Pediatric posterior-circulation aneurysms are uncommon, difficult-to-treat lesions associated with significant morbidity and mortality. Infections and trauma are important risk factors in children. Here, we present a 10-year-old boy with a lower respiratory tract infection, rapidly progressive right-neck swelling, and weakness of the right upper limb. Imaging revealed a partially thrombosed right vertebral-artery pseudoaneurysm with multiple cavitory lung lesions. Subsequent laboratory work-up showed underlying primary immunodeficiency disorder (chronic granulomatous disease). The aneurysm was successfully managed by parent-artery occlusion. The child made a complete recovery without neurological sequelae.

Keywords:
Vertebral artery, Mycotic aneurysm, Parent vessel occlusion, Chronic granulomatous disease
1.
Huang J, McGirt MJ, Gailloud P, Tamargo RJ: Intracranial aneurysms in the pediatric population: case series and literature review. Surg Neurol 2005; 63: 424–432.
2.
Sorteberg A, Dahlberg D: Intracranial non-traumatic aneurysms in children and adolescents. Curr Pediatr Rev 2013; 9: 343–352.
3.
Lasjaunias P, Wuppalapati S, Alvarez H, Rodesch G, Ozanne A: Intracranial aneurysms in children aged under 15 years: review of 59 consecutive children with 75 aneurysms. Childs Nerv Syst 2005; 21: 437–450.
4.
Krings T, Geibprasert S, terBrugge KG: Pathomechanisms and treatment of pediatric aneurysms. Childs Nerv Syst 2010; 26: 1309–1318.
5.
Jian BJ, Hetts SW, Lawton MT, Gupta N: Pediatric intracranial aneurysms. Neurosurg Clin N Am 2010; 21: 491–501.
6.
Patsalides AD, Wood LV, Atac GK, Sandifer E, Butman JA, Patronas NJ: Cerebrovascular disease in HIV-infected pediatric patients: neuroimaging findings. AJR Am J Roentgenol 2002; 179: 999–1003.
7.
Song E, Jaishankar GB, Saleh H, Jithpratuck W, Sahni R, Krishnaswamy G: Chronic granulomatous disease: a review of the infectious and inflammatory complications. Clin Mol Allergy 2011; 9: 10.
8.
Loffredo L, Carnevale R, Sanguigni V, Plebani A, Rossi P, Pignata C, et al: Does NADPH oxidase deficiency cause artery dilatation in humans? Antioxid Redox Signal 2013; 18: 1491–1496.
9.
Halbach VV, Higashida RT, Dowd CF, Fraser KW, Smith TP, Teitelbaum GP, et al: Endovascular treatment of vertebral artery dissections and pseudoaneurysms. J Neurosurg 1993; 79: 183–191.
10.
Islamoglu F, Posacioglu H, Memis A, Durmaz I: Endovascular transcatheter occlusion for traumatic vertebral artery pseudoaneurysm. Eur J Vasc Endovasc Surg 2000; 20: 576–578.
11.
Hasimoto K, Isaka F, Yamashita K: An infected aneurysm of the vertebral artery treated with a stent graft. Neurol Med Chir 2015; 55: 852–855.
© 2018 S. Karger AG, Basel
2018
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.