Diagnostic Characteristics and Management of Intracranial Aneurysms in Children

Agid, Ronit; Kimchi, Tali Jonas; Lee, Seon-Kyu; Brugge, Karel G. ter

doi:10.1016/j.nic.2007.02.001

Cited by 35 publications

(44 citation statements)

References 66 publications

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“…Multimodal treatment strategies are now widely used as a standard approach in the care of these patients [2,3,4,5,6,7] and have therefore resulted in significant improvements in patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Intracranial Aneurysms: An Institutional Experience

Vaıd¹,

Kumar²,

Kalra³

et al. 2008

Pediatr Neurosurg

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Introduction: Intracranial aneurysms are extremely uncommon in the pediatric population. Their epidemiology is poorly understood, and certain features make them unique. In our study we analyzed pediatric intracranial aneurysm patients to gain an insight into the epidemiology, clinicoradiological profile and outcome. Material and Methods: Out of 36 children (≤18 years of age; male:female ratio = 1.076:1; mean age 13.19 ± 3.72 years, age range 5–18 years) presenting with subarachnoid hemorrhage (SAH; n = 33; 91.67%) and mass effect (n = 3; 8.33%), 27 who were positive on digital subtraction angiography and treated for intracranial aneurysms between January 1991 and February 2007 were included in this study. Results: At presentation, the majority (n = 21) of the pediatric intracranial patients showed a good grade, and 23 (85.18%) presented with SAH. Sudden severe headache (n = 19; 70.37%) and loss of consciousness (n = 14; 51.85%) were the most common symptoms, and meningeal signs (n = 18; 66.66%) most commonly elicitable. There were 7 patients with giant aneurysms and 8 patients with posterior circulation aneurysms. Internal carotid artery (ICA) bifurcations (n = 6; 18.18%) followed by middle cerebral artery (MCA) bifurcations (n = 4; 12.12%) were the most common sites. At a mean follow-up of 18.67 ± 10.85 months (range 1–42 months), there were 21 (77.77%) patients with favorable outcome and 3 patients died. Conclusions: Intracranial aneurysms in children commonly present with SAH; there is a male predominance, and ICA bifurcations followed by MCA bifurcations are the most common sites. The incidence of posterior circulation aneurysms and giant aneurysms is higher as compared to adults. The pediatric patients present with better grades and have better overall surgical results.

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Section: Discussionmentioning

confidence: 99%

Pediatric Intracranial Aneurysms: An Institutional Experience

Vaıd¹,

Kumar²,

Kalra³

et al. 2008

Pediatr Neurosurg

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“…Unlike the adult population, there is male predominance, with a male-to-female ratio of approximately 3:2 to 1.9:1 [1,2,3,4]. Aneurysm location also differs in children, with the internal carotid artery being the most common site, accounting for 13-50% of the incidence, while posterior circulation aneurysms are also more frequent in children than in adults [2,3,4,5,6]. A reported series of 37 aneurysms found a frequency of 29.7% in the posterior circulation, with 10.8% in the PCA [7].…”

Section: Discussionmentioning

confidence: 99%

“…The most common clinical presentation was headache in 75% [6] and subarachnoid hemorrhage in 55-65% of the cases [4,5,6], followed by mass effect, epileptic seizures and cerebral vascular accidents [2,3,9]. Some authors had already noticed that rebleeding is more frequent in the pediatric population if compared to adults, occurring in up to 52% [2], possibly due to the delay in making the right diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Although observational studies have also suggested that children treated by endovascular therapy had a better outcome than those treated by surgical clipping, most of them are uncontrolled and small [22]. Agid et al [3] found good results in 77% of their endovascular group against only 44% in the surgically treated group, independently of Hunt and Hess grading. Lasjaunias et al [2] also reported a better outcome with endovascular treatment, with 7 of 8 treated patients having a good outcome.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence is very rare before 15 years of age, constituting 1% of all aneurysms [1]. Differences related to prevalence in sex, localization, morphology and etiology in childhood in comparison to the adult population are seen [2], with these characteristics becoming similar to adults in adolescence [3]. Recent advances of endovascular techniques have provided new therapeutic options.…”

Section: Introductionmentioning

confidence: 99%

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Endovascular Therapeutic Occlusion of the Posterior Cerebral Artery: An Option for Ruptured Giant Aneurysm in a Child

Demartini¹,

Matos²,

Santos³

et al. 2016

Pediatr Neurosurg

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The incidence of intracranial aneurysms in the pediatric population is low, and surgical clipping remains a good long-term treatment option. However, posterior circulation aneurysms are even more complex to manage in children than in adults. We report a case of a giant aneurysm of the posterior cerebral artery in a 10-year-old boy presenting with subarachnoid hemorrhage. Endovascular treatment with platinum coils was performed with total occlusion of the aneurysm and the affected arterial segment without complications. The patient achieved good recovery, and a late control angiogram confirmed exclusion of the aneurysm. Occurrence of special features of cerebral aneurysm in children, in comparison to adults, is also described. Parent artery sacrifice is an effective therapeutic option, but long-term follow-up is necessary to avoid recurrence and rebleeding.

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Pediatric Intracranial Aneurysms

Zeng¹,

Jiang²

2018

Textbook of Pediatric Neurosurgery

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Diagnostic Characteristics and Management of Intracranial Aneurysms in Children

Cited by 35 publications

References 66 publications

Pediatric Intracranial Aneurysms: An Institutional Experience

Pediatric Intracranial Aneurysms: An Institutional Experience

Endovascular Therapeutic Occlusion of the Posterior Cerebral Artery: An Option for Ruptured Giant Aneurysm in a Child

Pediatric Intracranial Aneurysms

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