First Reported Use of Onyx for the Treatment of a Traumatic Middle Cerebral Artery Pseudoaneurysm in a 3-Month-Old Infant

Background— Traumatic intracranial aneurysms are rare in the pediatric population.
Case Description— The authors treated a 3-month-old infant who presented with a distal right middle cerebral
artery traumatic pseudoaneurysm. At 9 days of age, the patient fell 2 feet to the floor sustaining a right parietal skull
fracture and subdural hematoma. He was initially managed conservatively but became symptomatic at 3 months of
age, at which time a magnetic resonance angiography identified the pseudoaneurysm. The patient successfully under
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went embolization of the pseudoaneurysm with Onyx 34 (Medtronic, Minneapolis, Minnesota, USA).
Conclusion— This is the first reported use of Onyx embolization for the management of traumatic pseudoaneu
-rysm in a pediatric patient.