Embolization of a giant pediatric, posttraumatic, skull base internal carotid artery aneurysm with a liquid embolic agent

Many treatments for posttraumatic, skull base aneurysms have been described Eight months after an all-terrain-vehicle accident. this 12-year-old girl presented with right-side Horner syndrome caused by it 33 x 19-mm internal carotid artery aneurysm at the C-1 level We chose to treat the aneurysm with a new liquid embolic agent for wide-necked. side wall aneurysms (Onyx HD 500) We fell this treatment would result in less morbidity than surgery and was less likely to occlude the parent artery than placement. of a covered stent. especially m a smaller artery in a pediatric patient Liquid embolic agents also appear to be associated with it lower chance of recanalization and lower cost compared with stent-assisted coil embolization. After the patient was treated with loading doses of aspirin. clopidogrel bisulfate, and heparm. 99% of the aneurysm was embolized with 9 cc of the liquid embolic agent There were no complications. and the patient remained neurologically stable Follow-tip angiography revealed durable aneurysm occlusion after I year The cost of Onyx was less than the cost of coils required for coil embolization of similarly sized intracranial aneurysms at our institution. Liquid embolic agents can provide a safe, efficacious, and cost-effective approach to treatment of select grant. posttraumatic. skull base aneurysms in pediatric patients (DOI: 10.3171/2009.6.PEDS0953)