Large Neonatal Paraophthalmic Aneurysm: a Case Report and Review of Literature

Neonatal intracranial aneurysm is a rare pathology that can pose significant challenges in diagnosis and treatment. There have only been 37 reported neonatal intracranial aneurysm cases in the literature to date, of which fewer than ten cases were treated endovascularly. We report a rare case of a newborn girl who underwent successful endovascular occlusion of the proximal part of the left internal carotid artery on the 15th day of life for a ruptured large paraophthalmic artery aneurysm. An MR angiogram at 3 months showed no flow within the aneurysm or embolized left ICA. The last MRI scan performed at 5 years of age continued to show no aneurysm recurrence. This is the first reported case of a neonatal paraophthalmic artery aneurysm. In this case, the collateral supply through the anterior communicating artery allowed embolization of the ipsilateral ICA, without neurological sequelae. We aim to raise the awareness of this entity for timely perinatal investigation and treatment.