METHODS: A 1-month-old infant presented with loss of consciousness and clonic movements of the right superior limb after a work-up for Hirschsprung\'s disease. His physical exam revealed stupor, miosis, anterior fontanelle swelling, and hyperreflexia of the right superior limb. Blood cultures were positive for Candida albicans. In addition, brain imaging revealed an intraparenchymal hematoma in the left temporal lobe and a saccular aneurysm at the M3 segment of the left middle cerebral artery. Upon careful discussion with the patient\'s family, he underwent evacuation of the hematoma and aneurysm repair. His postoperative clinical course was uneventful. At the 5-month follow-up, a brain MRI showed encephalomalacia in the area of prior hemorrhage. Furthermore, he had preserved motor function and adequate psychomotor development on subsequent pediatric evaluations.
CONCLUSIONS: Microsurgical management of ruptured mycotic aneurysms demands a systematic work-up and nuanced appraisal of clinical and aneurysmal factors. Operating in a confined space and considering the fragile nature of aneurysms are of utmost relevance for effectively treating these lesions.
方法:一名1个月大的婴儿在接受先天性巨结肠病后出现意识丧失和右上肢阵挛性运动。他的身体检查显示昏迷,瞳孔缩小,前font门肿胀,右上肢反射亢进.血液培养为白色念珠菌阳性。此外,脑成像显示左颞叶有实质内血肿,左大脑中动脉M3段有囊状动脉瘤.经过与病人家属的认真讨论,他接受了血肿和动脉瘤修复术。他的术后临床过程顺利。在5个月的随访中,脑部MRI显示先前出血区域的脑软化。此外,在随后的儿科评估中,他保留了运动功能和足够的精神运动发育。
结论:对破裂的霉菌性动脉瘤的显微外科治疗需要对临床和动脉瘤因素进行系统的检查和细致的评估。在狭窄的空间中进行手术并考虑动脉瘤的脆弱性质对于有效治疗这些病变至关重要。