Thankfully they're rare, but very serious when they do occur. So, what is a brain aneurysm in children and what can be done to treat the condition?
An aneurysm is a lesion that can affect the arteries in different locations throughout the body. An aneurysm presents as a bubble-like blistering or protrusion from an artery.
In the brain, the aneurysms usually appear at predictable locations where the major arteries divert into smaller ones. Aneurysms occur in the deep crevices that are situated between the different lobes of the brain, rather than in the brain tissue itself.
The majority of aneurysms occur in older people, usually in their 40s or 50s, but are very rarely found in children. Of those children affected, the majority are male.
Establishing brain aneurysm in children can be difficult, especially if the child is too young to effectively verbalize what they are feeling.
The main symptom of a ruptured aneurysm is a crippling headache, usually described as ‘the worst headache of your life’. This is often accompanied by vomiting, a lack of tolerance to light (photophobia), and a stiff neck.
Your child may also have difficulty walking or standing and may appear confused.
In severe cases, death may occur. In fact, 50% of brain aneurysms result in the death of the sufferer. Of those that do survive, it is highly likely that re-bleeding may occur within the following couple of weeks.
A ruptured brain aneurysm in children is often mimicked by meningitis. Both these conditions cause headaches, fever, a stiff neck and sensitivity to light. The main differences from an initial diagnostic perspective are that there should be a much more significant fever in cases of meningitis, and the headache experienced is usually much more severe in a brain aneurysm.
A definitive diagnosis is usually made by carrying out an emergency CT or MRI scan and sampling the spinal fluid via a lumbar puncture. The ultimate test for a brain aneurysm in children is usually an arteriogram followed by an angiogram to give a clear picture of the anatomy of a brain aneurysm, its location, and its severity.
Once located, virtually all brain aneurysms require treatment. They are repaired by placing clips at the base of the brain aneurysm where it arises from the artery, taking care not to compromise or damage the blood vessels, as this could risk causing a stroke.
In the event that non-ruptured aneurysms are discovered, a catheter may be inserted into the artery, leading to the abnormal blood vessel in the brain. Various materials are then used to ‘plug’ the brain aneurysm to prevent it from rupturing.
Once a brain aneurysm has been successfully treated, the patient should be cured. However, there may be complications arising from the initial bleeding.
In some children who have suffered a ruptured aneurysm, there may be a ‘clamping down’ of the blood vessels around the site. This ‘vasospasm’ can cause a decrease in the blood supply to the brain, causing loss of function to part of the brain. This loss of function may be temporary or permanent and generally occurs in the first three to 10 days following the aneurysm. Treatment entails maintaining the best blood supply possible to that area of the brain and providing supportive care until the condition resolves.
Although brain aneurysms in children do not occur very often, they can be potentially lethal and it is important to understand and recognize the symptoms. If your child complains of a severe headache, stiff neck and feels nauseous, always take them to your local emergency room immediately.
Prompt diagnosis and treatment is essential to give the child the best chance of making a full recovery.