[Anesthesia with controlled hypotension for treatment of intracranial arterial aneurysm in an infant].

A case is reported of a ruptured intracranial aneurysm of the posterior cerebral artery in a 21/2 month old infant. The clinical picture of subarachnoid haemorrhage included coma, seizures and left hemiparesis. The aneurysm was detected by two dimensional ultrasonography and CT scan. The carotid and vertebral arteriogram showed an aneurysm located on the posterior cerebral artery. Surgery was performed after neurological improvement, 25 days after admission. The operation was conducted under controlled systemic hypotension using sodium nitroprusside. The mean blood pressure was decreased from 70 mmHg to 40 mmHg during 20 min. This technique established good haemostatic conditions during removal of the aneurysm. Postoperative recovery was uneventful with full neurological recovery. The interest of sodium nitroprusside as a hypotensive agent is discussed. The difficulties of monitoring haemodynamic variables in infants are stressed.