Ruptured Giant Middle Cerebral Artery Aneurysm in Infancy (P3.115)
Bibliographic record
Abstract
OBJECTIVE:Intracranial aneurysms are rare in children and represent less than 5[percnt] of the total population. Rupture of intracranial aneurysms is potentially life threatening and frequently presents with subarachnoid rather than ICH.BACKGROUND:Giant aneurysms occur in up to 50[percnt] of pediatric cases as compared to 27[percnt] in adults. However, multiple aneurysms are less common in children (3-5[percnt]) than in adults (10-20[percnt]). The occurrence of aneurysms is probably the result of an interplay between congenital factors and hemodynamic stresses.DESIGN/METHOD: An 11-month-old girl presented to the emergency unit with acute lethargy and unresponsiveness followed by generalized tonic clonic seizures. She was previously healthy with no recent history of fever or trauma. Her initial Glasgow coma scale was 6 with tense anterior fontanel and fixed dilated left pupil. She was mechanically ventilated, loaded with phenytoin, and received mannitol. She was then taken to the operating room for urgent craniotomy and evacuation of the hematoma. During the procedure, a giant left MCA aneurysm was evident. After consulting with the family, clipping of the giant aneurysm was performed. Post-operative CT demonstrated the successful evacuation of the intracerebral hematoma and clipping of the left MCA aneurysm with some ischemic changes involving the left sylvian region and temporal lobe. MRA was also requested and revealed paucity of the left MCA branches with filling of the main MCA, both suggestive of successful clipping. Results:Follow up arterial angiography revealed no residual or other aneurysms. On further follow up, she had motor delay and recurrent partial seizures.A brain MRI revealed a residual left MCA territory ischemic infarction. Active physiotherapy was performed and she could walk independently by age 3. On last follow up at age 3.5 years, she was functioning independently.Conclusion:intracranial aneurysms have to be considered in the differential diagnosis of infants presenting with raised intracranial pressure.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".