Figure 1

Aneurysm of the middle cerebral artery

Axial (images 1, 2) and sagittal (image 3) CT angiogram images display a middle cerebral artery aneurysm (arrow), which is partially thrombosed, as well as thrombosis of a portion of the right middle cerebral artery. Collateral vessels are observed distally. Pediatric cerebral aneurysms may be related to various conditions, including collagen vascular diseases, connective tissue disorders, trauma, and infections. They are most commonly found at the internal carotid artery bifurcation.

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Continuation of the HSA Case
After the patient had placed the external ventricular shunt, the patient was referred to the endovascular treatment center where a cerebral vessel arteriography was performed with the use of a 3D reconstruction to reduce the time of examination and contrast in the patient where A baby aneurysm was diagnosed in the bifurcation of the carotid artery and another ruptured bilocular aneurysm of the large neck in the right middle cerebral artery, which caused HSA.
Thus, we started the endovascular treatment with the use of a balloon microcatater to stabilize and help to place the micromoles within the large neck aneurysm with greater precision and without the risk of them entering the light of the middle cerebral artery and obstructing the same causing further damage Greater in the patient and close the aneurysm as soon as possible, thus reducing cerebral bleeding.
After placing the micromoles in the ruptured aneurysm we removed the microballoon and performed a final arteriography to visualize the aneurysm closure and if we did not have any evident damage in the vessels of the middle cerebral where everything was within normality and the aneurysm was successfully treated.
Diagnostic conclusion: right hemisphere HSA caused by acute middle cerebral artery aneurysm bleeding treated.](https://app.figure1.com/case-detail/1c1e0ba3-7d19-4c4c-b4f5-d4c35ac588e0)



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