Parry Romberg Syndrome Presenting With A Giant Intracranial Aneurysm: A Case Report

A giant intracranial aneurysm was diagnosed in a 10-year-old girl when she developed a right abducens nerve palsy. The aneurysm was treated successfully. Six years later, however, she presented with a progressive en coup de sabre deformity, leading to the diagnosis Parry Romberg Syndrome (PRS), a rare diagnosis characterized by hemifacial atrophy of skin, subcutaneous tissue, skeletal muscle and bones and often associated with various non-specific intracerebral abnormalities. In this patient retrospective analysis of computed tomography and magnetic resonance imaging imaging indeed revealed intracerebral calcifications and a specific white matter lesions. Remarkably, in this patient the giant intracranial aneurysm turned out to be the presenting symptom of PRS years before the characteristic facial deformities became apparent.