Intracranial aneurysms in the pediatric population: case series and literature review

Huang, Judy; McGirt, Matthew J.; Gailloud, Philippe; Tamargo, Rafael J.

doi:10.1016/j.surneu.2004.11.023

Cited by 221 publications

(210 citation statements)

References 58 publications

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“…Mortality from SAH decreased by 79%, and mortality from IPH declined 58%. Improvements in pediatric critical care and neurosurgical techniques may account from some of this reduction in mortality [7,72]. Pooled data from multiple, somewhat heterogeneous studies suggest an average mortality of 25% in children with HS [6], although individual study estimates range from 7% [73] to 54% [22].…”

Section: Neurologic Outcome and Hs Recurrencementioning

confidence: 99%

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Hemorrhagic Stroke in Children

Jordan

Hillis

2007

Pediatric Neurology

113

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Hemorrhagic stroke accounts for approximately half of stroke in childhood. Unlike arterial ischemic stroke, there are no consensus guidelines to assist in the evaluation and treatment of these children. We review the literature on the evaluation, treatment, etiology and neurologic outcome of hemorrhagic stroke in children. Important differences between pediatric and adult hemorrhage are highlighted, as treatment guidelines for adults may not be applicable in all cases. Needed future research and potential therapies are also discussed.

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Section: Neurologic Outcome and Hs Recurrencementioning

confidence: 99%

“…Non-traumatic SAH is most often due to intracranial aneurysm and is evaluated and treated differently, though like IPH, recommendations for childhood SAH are based on the adult literature. Two recent pediatric intracranial aneurysm case series and reviews of the literature are available [7,8].…”

Section: Introductionmentioning

confidence: 99%

Hemorrhagic Stroke in Children

Jordan

Hillis

2007

Pediatric Neurology

113

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“…Other reports have commonly observed angiographic vasospasm in children who present with aneurysm rupture but have rarely noted its clinical significance. 10,13,19,21,23,26,38 In children younger than 2 years of age, however, vasospasm can be severe, possibly leading to debilitating large-vessel strokes, 34 probably due to high blood vessel reactivity. Reports on the use of nimodipine to reduce the risk of deficit from clinical vasospasm in children with aneurysmal SAH are limited, although its use in adults has been evaluated in the literature.…”

Section: Treatmentmentioning

confidence: 99%

“…12,15,17,29 As in adults, the treatment of intracranial aneurysms in children can involve microsurgical clip ligation, wrapping, and endovascular treatment including flow diversion, coiling, and embolization of the aneurysm and parent vessel. 1,13,14,20,30,34,37 The rate of new SAH is higher in both adults and children with a previous aneurysm rupture than in the general population; it occurs as a result of recurrent aneurysms as well as de novo aneurysm formation. 4,35,39 In pediatric patients with a mean follow-up of 4-6 years, 11,15,30 a 13%-23% cumulative rate of de novo aneurysm formation has been reported.…”

mentioning

confidence: 99%

“…1,13,14,20,30,34,37 The rate of new SAH is higher in both adults and children with a previous aneurysm rupture than in the general population; it occurs as a result of recurrent aneurysms as well as de novo aneurysm formation. 4,35,39 In pediatric patients with a mean follow-up of 4-6 years, 11,15,30 a 13%-23% cumulative rate of de novo aneurysm formation has been reported.…”

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confidence: 99%

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Rapid de novo aneurysm formation after clipping of a ruptured middle cerebral artery aneurysm in an infant with an MYH11 mutation

Ravindra

Karsy

Schmidt

et al. 2016

PED

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The authors report the case of a previously healthy 6-month-old girl who presented with right arm and leg stiffening consistent with seizure activity. An initial CT scan of the head demonstrated acute subarachnoid hemorrhage in the basal cisterns extending into the left sylvian fissure. Computed tomography angiography demonstrated a 7 × 6 × 5–mm saccular aneurysm of the inferior M2 division of the left middle cerebral artery. The patient underwent left craniotomy and microsurgical clip ligation with wrapping of the aneurysm neck because the vessel appeared circumferentially dysplastic in the region of the aneurysm. Postoperative angiography demonstrated a small remnant, sluggish distal flow, but no significant cerebral vasospasm. Fifty-five days after the initial aneurysm rupture, the patient presented again with an acute intraparenchymal hemorrhage of the left anterior temporal lobe. Angiogram revealed a circumferentially dysplastic superior division of the M2 branch, with a new 5 × 4–mm saccular aneurysm distinct from the first, with 2 smaller aneurysms distal to the new ruptured aneurysm. Endovascular parent vessel occlusion with Onyx was performed. Genetic testing revealed a mutation of the MYH11. To the authors' knowledge, this is the first report of rapid de novo aneurysm formation in an infant with an MYH11 mutation. The authors review the patient's clinical presentation and management and comprehensively review the literature on this topic.

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Paediatric stroke - reading list

2013

World Stroke Academy

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Intracranial aneurysms in the pediatric population: case series and literature review

Cited by 221 publications

References 58 publications

Hemorrhagic Stroke in Children

Hemorrhagic Stroke in Children

Rapid de novo aneurysm formation after clipping of a ruptured middle cerebral artery aneurysm in an infant with an MYH11 mutation

Paediatric stroke - reading list

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