{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T11:07:52Z","timestamp":1779361672115,"version":"3.51.4"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"19","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,5,11]]},"abstract":"\n BACKGROUND<\/jats:title>\n The authors report the case of an 11-year-old boy who presented with sudden-onset severe headache owing to a subarachnoid hemorrhage (SAH) due to rupture of an anterior communicating artery aneurysm.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n Clinical examination revealed a discrepancy in blood pressure between the upper and lower extremities, prompting further cardiovascular evaluation. Imaging identified a previously undetected coarctation of the distal aortic arch (CoA). The patient had been considered healthy and asymptomatic prior to presentation.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n The coexistence of CoA and an intracranial aneurysm (IA) is rare in pediatric patients and poses significant management challenges. Treatment involved surgical clipping of the ruptured IA, followed by repair of the CoA in a staged approach. This highlights the importance of prioritizing cerebrovascular risk while planning for cardiovascular correction.<\/jats:p>\n This case emphasizes the need for early, comprehensive cardiovascular and cerebrovascular assessment in children presenting with SAH. Multidisciplinary collaboration is essential to address both acute and long-term risks, including recurrence of IA or complications related to CoA. Blood pressure monitoring and long-term follow-up with cerebrovascular imaging are critical. Reporting such cases is vital for understanding the association between CoA and IA and in refining diagnostic and therapeutic strategies for this uncommon but clinically significant scenario.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25991<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25991","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T16:15:29Z","timestamp":1778516129000},"source":"Crossref","is-referenced-by-count":0,"title":["Coarctation of the aorta and subarachnoid hemorrhage from an anterior communicating artery aneurysm in an 11-year-old: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"given":"Valerie N. E.","family":"Schuermans","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Maastricht University Medical Centre+, Maastricht"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jort P. M.","family":"Pit","sequence":"additional","affiliation":[{"name":"Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esmee M. R.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Intensive Care, Maastricht University Medical Centre+, Maastricht"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joost","family":"Nicolai","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology, Maastricht University Medical Centre+, Maastricht"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Frerich","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jim T. A.","family":"Dings","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Maastricht University Medical Centre+, Maastricht"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roel H. L.","family":"Haeren","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Maastricht University Medical Centre+, Maastricht"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rick H. G. J.","family":"van Lanen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Maastricht University Medical Centre+, Maastricht"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"bib1","article-title":"Coarctation of the aorta","author":"Law","unstructured":"Law MACollier SASharma STivakaran VS.Coarctation of the aorta. In: StatPearls. StatPearls Publishing; 2024."},{"issue":"6","key":"bib2","series-title":"AJNR Am J Neuroradiol","first-page":"1182","article-title":"Results of screening for intracranial aneurysms in patients with coarctation of the aorta","volume":"33","author":"Curtis","year":"2012","unstructured":"Curtis SLBradley MWilde PResults of screening for intracranial aneurysms in patients with coarctation of the aorta. AJNR Am J Neuroradiol. 2012;33(6):1182-1186. doi:10.3174\/ajnr.A2915"},{"issue":"1","key":"bib3","series-title":"Pediatr Cardiol","first-page":"1","article-title":"Hypertension in coarctation of the aorta: challenges in diagnosis in children","volume":"39","author":"Vigneswaran","year":"2018","unstructured":"Vigneswaran TVSinha MDValverde ISimpson JMCharakida M.Hypertension in coarctation of the aorta: challenges in diagnosis in children. 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J Neurol Surg A Cent Eur Neurosurg. 2022;83(3):286-289. doi:10.1055\/s-0040-1721000"},{"issue":"5","key":"bib5","series-title":"Surg Neurol","first-page":"424","article-title":"Intracranial aneurysms in the pediatric population: case series and literature review","volume":"63","author":"Huang","year":"2005","unstructured":"Huang JMcGirt MJGailloud PTamargo RJ.Intracranial aneurysms in the pediatric population: case series and literature review. Surg Neurol. 2005;63(5):424-432. doi:10.1016\/j.surneu.2004.11.023"},{"issue":"2","key":"bib6","series-title":"J Neurosurg","first-page":"82","article-title":"Pediatric intracranial aneurysms: durability of treatment following microsurgical and endovascular management","volume":"104","author":"Sanai","year":"2006","unstructured":"Sanai NQuinones-Hinojosa AGupta NMPediatric intracranial aneurysms: durability of treatment following microsurgical and endovascular management. J Neurosurg. 2006;104(2)(suppl):82-89. doi:10.3171\/ped.2006.104.2.3"},{"issue":"8","key":"bib7","series-title":"Stroke","first-page":"2368","article-title":"Guidelines for the management of patients with unruptured intracranial aneurysms: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"46","author":"Thompson","year":"2015","unstructured":"Thompson BGBrown RDJrAmin-Hanjani SGuidelines for the management of patients with unruptured intracranial aneurysms: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association. Stroke. 2015;46(8):2368-2400. doi:10.1161\/STR.0000000000000070"},{"issue":"13","key":"bib8","series-title":"Diagnostics (Basel)","first-page":"2189","article-title":"Coarctation of the aorta: diagnosis and management","volume":"13","author":"Raza","year":"2023","unstructured":"Raza SAggarwal SJenkins PCoarctation of the aorta: diagnosis and management. 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J Stroke. 2020;22(1):76-86. doi:10.5853\/jos.2019.01312"},{"key":"bib17","series-title":"World Neurosurg","first-page":"31","article-title":"Surgery or endovascular treatment in patients with anterior communicating artery aneurysm: a systematic review and meta-analysis","volume":"175","author":"Sattari","year":"2023","unstructured":"Sattari SAShahbandi ALee RPSurgery or endovascular treatment in patients with anterior communicating artery aneurysm: a systematic review and meta-analysis. World Neurosurg. 2023;175:31-44. doi:10.1016\/j.wneu.2023.03.111"},{"key":"bib1","article-title":"Coarctation of the aorta","author":"Law","unstructured":"Law MACollier SASharma STivakaran VS.Coarctation of the aorta. In: StatPearls. 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J Neurosurg. 2006;104(2)(suppl):82-89. doi:10.3171\/ped.2006.104.2.3"},{"issue":"8","key":"bib7","series-title":"Stroke","first-page":"2368","article-title":"Guidelines for the management of patients with unruptured intracranial aneurysms: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"46","author":"Thompson","year":"2015","unstructured":"Thompson BGBrown RDJrAmin-Hanjani SGuidelines for the management of patients with unruptured intracranial aneurysms: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association. Stroke. 2015;46(8):2368-2400. doi:10.1161\/STR.0000000000000070"},{"issue":"13","key":"bib8","series-title":"Diagnostics (Basel)","first-page":"2189","article-title":"Coarctation of the aorta: diagnosis and management","volume":"13","author":"Raza","year":"2023","unstructured":"Raza SAggarwal SJenkins PCoarctation of the aorta: diagnosis and management. Diagnostics (Basel). 2023;13(13):2189. doi:10.3390\/diagnostics13132189"},{"issue":"6","key":"bib9","series-title":"J Child Neurol","first-page":"773","article-title":"Evolution of management of intracranial aneurysms in children: a systematic review of the modern literature","volume":"31","author":"Beez","year":"2016","unstructured":"Beez TSteiger H-JH\u00e4nggi D.Evolution of management of intracranial aneurysms in children: a systematic review of the modern literature. J Child Neurol. 2016;31(6):773-783. doi:10.1177\/0883073815609153"},{"issue":"10","key":"bib10","series-title":"Childs Nerv Syst","first-page":"1329","article-title":"Cerebral aneurysms in children: are we talking about a single pathological entity?","volume":"26","author":"Requejo","year":"2010","unstructured":"Requejo FCeciliano ACardenas RVillasante FJaimovich RZuccaro G.Cerebral aneurysms in children: are we talking about a single pathological entity? 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