BACKGROUND : Aneurysm rerupture and bilateral fixed and dilated pupils (bFDPs) typically have a poor prognosis across all age groups. The synchronous occurrence of both features in the infantile demographic has not been previously reported. METHODS : We describe the near-fatal clinical course of a 7-month-old infant who experienced an acute giant aneurysm rerupture with signs of bFDPs. The patient was rapidly managed with neurosurgical intervention and has achieved a favorable outcome 1 year later. CONCLUSIONS : This case highlights that survival of infants who present with intracranial aneurysmal rerupture and bFDPs is amenable to rapid neurosurgical intervention and should be remembered in clinical practice.
