Aneurisma gigante de arteria vertebral en paciente de edad pediátrica

OBJECTIVE: To describe the case of a pediatric patient with a giant vertebral artery aneurysm treated with microsurgical clipping. MATERIALS AND METHODS: Sixteen patients were treated in our institution in the past 5 years. Only two cases were vertebral artery aneurysms. We describe the case of an 11-year-old patient with history of hiccups episodes. He also complained of horizontal diplopia. Magnetic resonance angiography and digital subtraction angiography (DSA) were performed to assess diagnosis. We decided to perform a modified far-lateral approach without condyle drilling to surgically clip the lesion. There was complete resolution of symptoms and DSA showed aneurysm completely occluded. CONCLUSION: Giant vertebral artery aneurysm treatment required to exclude the lesion permanently and diminish mass effect. Surgical clipping is an effective option to assure permanent exclusion of circulation and complete resolution of the lesion.