Pseudoaneurysm Formation in a Pediatric Patient After Non-Traumatic Middle Cerebral Artery Dissection With a Rapid Spontaneous Complete Thrombosis

Spontaneous cerebral dissections in children are rare and can be associated with the formation of pseudoaneurysms. The management of these pseudoaneurysms is controversial as they can be treated either by surgery or endovascular techniques. On rare occasions, they may spontaneously thrombose. We present a 12-year-old male without a history of trauma who developed an intracerebral hematoma secondary to a ruptured pseudoaneurysm of the middle cerebral artery that showed a rapid spontaneous complete thrombosis. Five days after his initial diagnostic cerebral digital subtraction angiogram, a follow-up study showed no evidence of the previously observed pseudoaneurysm. Two months later, a computed tomographic angiography of the brain showed no evidence of the pseudoaneurysm. Thrombosed pseudoaneurysms should be closely followed by neuroimaging studies as they may subsequently recanalize.