婴儿颅内霉菌性动脉瘤破裂的显微手术治疗。

IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY
Child's Nervous System Pub Date : 2024-11-01 Epub Date: 2024-06-27 DOI:10.1007/s00381-024-06505-6
Orlando Sánchez-Orbegoso, Jhon E Bocanegra-Becerra, Rolando Rojas-Apaza, José Cenzano-Ramos
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引用次数: 0

摘要

导言:在婴儿期,感染性动脉瘤是一种不常见且可能致命的病变,极有可能导致颅内出血:一名 1 个月大的婴儿在接受赫氏脓肿病检查后出现意识丧失和右上肢阵挛性运动。他的体格检查显示昏迷、瞳孔缩小、前囟门肿胀和右上肢反射亢进。血液培养呈白色念珠菌阳性。此外,脑成像显示左侧颞叶有一个实质内血肿,左侧大脑中动脉 M3 段有一个囊状动脉瘤。在与患者家属仔细讨论后,他接受了血肿清除术和动脉瘤修补术。术后临床过程顺利。在 5 个月的随访中,脑部核磁共振成像显示之前出血的区域出现了脑畸形。此外,在随后的儿科评估中,他的运动功能得以保留,精神运动发育良好:结论:对破裂的霉菌性动脉瘤进行显微手术治疗需要系统的检查,并对临床和动脉瘤因素进行细致的评估。在狭小的空间内进行手术,并考虑到动脉瘤的脆弱性,对于有效治疗这些病变至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Microsurgical management of a ruptured intracranial mycotic aneurysm in infancy.

Microsurgical management of a ruptured intracranial mycotic aneurysm in infancy.

Introduction: During infancy, infectious aneurysms are uncommon and potentially fatal lesions with an imminent risk of intracranial hemorrhage development.

Case presentation: A 1-month-old infant presented with loss of consciousness and clonic movements of the right superior limb after a work-up for Hirschsprung's disease. His physical exam revealed stupor, miosis, anterior fontanelle swelling, and hyperreflexia of the right superior limb. Blood cultures were positive for Candida albicans. In addition, brain imaging revealed an intraparenchymal hematoma in the left temporal lobe and a saccular aneurysm at the M3 segment of the left middle cerebral artery. Upon careful discussion with the patient's family, he underwent evacuation of the hematoma and aneurysm repair. His postoperative clinical course was uneventful. At the 5-month follow-up, a brain MRI showed encephalomalacia in the area of prior hemorrhage. Furthermore, he had preserved motor function and adequate psychomotor development on subsequent pediatric evaluations.

Conclusion: Microsurgical management of ruptured mycotic aneurysms demands a systematic work-up and nuanced appraisal of clinical and aneurysmal factors. Operating in a confined space and considering the fragile nature of aneurysms are of utmost relevance for effectively treating these lesions.

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来源期刊
Child's Nervous System
Child's Nervous System 医学-临床神经学
CiteScore
3.00
自引率
7.10%
发文量
322
审稿时长
3 months
期刊介绍: The journal has been expanded to encompass all aspects of pediatric neurosciences concerning the developmental and acquired abnormalities of the nervous system and its coverings, functional disorders, epilepsy, spasticity, basic and clinical neuro-oncology, rehabilitation and trauma. Global pediatric neurosurgery is an additional field of interest that will be considered for publication in the journal.
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