Survival of a 2-month-old infant after clipping of ruptured middle cerebral artery aneurysm: A case report and review of the literature

Background: Intracranial aneurysms (IA) are rare in the pediatric population but represent distinct characteristics from adult cases. Due to the limited literature, management is challenging as there are no clear treatment guidelines for such cases. We report a case of ruptured intracranial middle cerebral artery (MCA) aneurysm in an infant treated by clipping with a current review of the literature. Case Description: A 2-month-old male with a history of atrial septal defect and a recent head injury was referred to the hospital due to imaging findings of subarachnoid hemorrhage in the left Sylvian cistern, extending over the left hemispheric sulci, and intraventricular hemorrhage caused by a ruptured left MCA aneurysm. Urgent aneurysmal clipping and external ventricular drain insertion were performed. Conclusion: This case demonstrated an overall positive outcome, with successful repair and increased survival in the patient despite the poor prognosis associated with mycotic IA, and supports microsurgical clipping as the preferred treatment approach for better outcomes. However, further studies are needed on a larger population.