Pediatric emergency medicine trisk 4002 4002

FIGURE 122.1 Axial CT of the brain shows hyperdensity consistent with aneurysm
associated with acute hemorrhage in the basal cisterns. The prominence of the temporal
horns of the lateral ventricles is also indicative of acute hydrocephalus.

Management. Spontaneous cerebral aneurysms presenting with bleeding
are uncommon but should be treated because of a poor natural history.
Imaging should be first acquired, and only if mass effect is not detected and
a high suspicion of aneurysmal rupture still exists should a lumbar puncture
be attempted. Aggressive surgical management with clipping, resection, or
trapping of intracranial dissecting aneurysms by surgical or endovascular
methods seems the most appropriate treatment.
Cavernous Malformation