A previously well, 14-month-old girl presented with acute decreased level of consciousness. There was no history of trauma, systemic upset or significant family history. Blood pressure was within normal range and no focal neurological deficit was elicited on examination. Neuroimaging revealed a subarachnoid haemorrhage secondary to a basilar tip aneurysm. Patient underwent endovascular embolisation with good clinical outcome. Follow-up MRI revealed anterior circulation vasospasm, and although clinically asymptomatic, she was treated with a calcium channel antagonist. She was later discharged home with no neurological deficit. Follow-up MRI 3 months following presentation suggested recurrent formation of the aneurysmal sac. The patient then underwent elective endovascular repair 2 months later and was discharged home on antiplatelet therapy with planned close outpatient clinical and radiological surveillance.
- neonatal and paediatric intensive care
- interventional radiology
- vascular surgery
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Contributors PM is involved in the care of the patient in PICU and co-wrote this article with STO (an Interventional neuroradiology registrar) and myself (AJT). PM also liaised with patients' parents throughout the process and engaged their participation with patient perspective section and was responsible for planning report and first draft format. This was reviewed, edited and adjusted by AJT. STO was involved to provide more technical expertise in the neuroradiology field. MS and IR were both closely involved in this patients' management throughout their journey.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Parental/guardian consent obtained.
Provenance and peer review Not commissioned; externally peer reviewed.