When a 13-year-old boy, studying sixth standard, was attending online class, went to the restroom during lunch break and suddenly fell down. After he regained consciousness, the boy had severe headache and vomiting. His parents immediately rushed him to a nearby hospital. He underwent radiological imaging for the brain which revealed blood clots. He was then brought to Apollo Specialty Hospitals.
A team of doctors, who examined the patient, found a ruptured brain aneurysm in a major blood vessel inside his brain. His parents were appraised of his condition and further treatment planning was done. He was shifted to the operation theatre within three hours and underwent a successful microsurgical keyhole clipping surgery.
Since the patient tested positive for COVID-19, he was shifted to COVID care unit and treated for the brain aneurysm and COVID-19. He recovered gradually in about five days and was discharged without any problems.
Speaking to reporters here on Tuesday, doctors led by neurosurgeon Shyam, S.N. Karthik, Nisha B, Kevin Joseph, Padmaprakash, Murugan Jeyaraman and others, said aneurysms in pediatric cases were very rare, constituting 0.6–4% of all intracranial aneurysms.
Acquired risk factors like smoking, hypertension, diabetes, and hypercholesterolemia seen in adults are absent in children. It is predominantly congenital factors and hemodynamic stresses that play a role in the development of aneurysms in children, they said.
While considering the management of aneurysms in children, the safety and long-term efficacy of the treatment must be kept in mind. They often require advanced surgical techniques and a skilled neurovascular team to achieve good outcomes, they added.
This surgery offers a relatively safe and a durable option with excellent long-term results. Early identification, quick treatment and quality post-operative care are essential for good outcomes. “We advocate lifetime vigilance and angiographic follow-up as the annual risks of hemorrhage (0.6%), recurrence (2.6%), and de novo formation (7.8%) are high.” said Rohini Sridhar, senior vice-president, Hospitals Division, Apollo Hospitals.
