Bilateral giant cavernous carotid artery aneurysms in a child with juvenile Paget's disease.

Abstract

Juvenile Paget disease (JPD) is a rare genetic bone disorder, also affecting the immune and vascular systems. We describe the first ever case of JPD associated with bilateral giant cavernous carotid artery aneurysms in a child. A child with known JPD presented with left abducens nerve palsy and a computed tomographic angiogram revealed bilateral giant cavernous carotid artery aneurysms. He underwent a left-sided superficial temporal artery to middle cerebral artery bypass and endovascular carotid artery occlusion, followed by an identical procedure on the right side 3 months later and made an event-free recovery without any new neurological deficits. This previously unreported association poses the question of determining the optimal management strategy for such cases. The pathophysiology and clinical features of JPD are discussed, with special emphasis on the management of giant cavernous carotid aneurysms in this subgroup of individuals.