Introduction: Iatrogenic intracranial aneurysms are rare in children.
Case report: A 15-year-old girl presented in coma with a fixed dilated left pupil six weeks following removal of a long-standing left-sided ventriculoperitoneal shunt. Computed tomography (CT) and cerebral angiography revealed a left temporoparietal intracerebral haemorrhage with a fusiform distal middle cerebral artery aneurysm. The patient underwent image-guided localisation of the aneurysm to enable evacuation of the haemorrhage and resection of the fusiform aneurysm.
Conclusion: A high index of suspicion is required for diagnosis and early treatment to prevent unnecessary morbidity and mortality.