Repair process in spontaneous intradural dissecting aneurysms in children: report of eight patients and review of the literature

Songsaeng, Dittapong; Srivatanakul, Kittipong; Toulgoat, F.; Saliou, Guillaume; Ozanne, Augustin; Lasjaunias, P.

doi:10.1007/s00381-008-0698-1

Cited by 21 publications

(19 citation statements)

References 20 publications

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“…In dissecting aneurysms, mural hematoma seems to be the most important promoting factor for spontaneous thrombosis and healing of the aneurysm [21]. …”

Section: Treatmentmentioning

confidence: 99%

Intracranial Non-traumatic Aneurysms in Children and Adolescents

Sorteberg

Dahlberg

2013

CPR

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An intracranial aneurysm in a child or adolescent is a rare, but potentially devastating condition. As little as approximately 1200 cases are reported between 1939 and 2011, with many of the reports presenting diverting results. There is consensus, though, in that pediatric aneurysms represent a pathophysiological entity different from their adult counterparts. In children, there is a male predominance. About two-thirds of pediatric intracranial aneurysms become symptomatic with hemorrhage and the rate of re-hemorrhage is higher than in adults. The rate of hemorrhage from an intracranial aneurysm peaks in girls around menarche. The most common aneurysm site in children is the internal carotid artery, in particular at its terminal ending. Aneurysms in the posterior circulation are more common in children than adults. Children more often develop giant aneurysms, and may become symptomatic from the mass effect of the aneurysm (tumorlike symptoms). The more complex nature of pediatric aneurysms poses a larger challenge to treatment alongside with higher demands to the durability of treatment. Outcome and mortality are similar in children and adults, but long-term outcome in the pediatric population is influenced by the high rate of aneurysm recurrences and de novo formation of intracranial aneurysms. This urges the need for life-long follow-up and screening protocols.

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“…In dissecting aneurysms, mural hematoma seems to be the most important promoting factor for spontaneous thrombosis and healing of the aneurysm [21]. …”

Section: Treatmentmentioning

confidence: 99%

Intracranial Non-traumatic Aneurysms in Children and Adolescents

Sorteberg

Dahlberg

2013

CPR

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“…Koroknay-Pal et al (24) and Liang et al (25) also reported the same phenomenon. A mural hematoma appears to be the most important promoting factor for spontaneous thrombosis and healing of aneurysms (4). …”

Section: Discussionmentioning

confidence: 99%

“…Giant aneurysms are relatively common among pediatric patients with intracranial aneurysms (3). There have been few reports on children with IDAs (4, 5). This study aimed to analyze the clinical presentation, aneurysm characteristics, and treatment outcome of IDAs in patients aged 18 years or younger at our center over the last 6 years.…”

Section: Introductionmentioning

confidence: 99%

Treatment for Spontaneous Intracranial Dissecting Aneurysms in Childhood: A Retrospective Study of 26 Cases

Zhang

Wang

et al. 2016

Front. Neurol.

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ObjectiveThis study aimed to assess the clinicoradiological features and treatment outcomes of intracranial dissecting aneurysms (IDAs) in childhood.MethodsWe conducted a retrospective study of pediatric patients who were treated for spontaneous IDAs in our institute between January 2010 and December 2015. The clinical presentation, aneurysm characteristics, treatment modality, and outcome were studied.ResultsWe studied 26 pediatric patients (mean age, 13.4 years; range, 4–18 years) with 31 IDAs who comprised 6.9% of all IDA patients treated during the same period. Seventeen (65.4%) patients were males, and nine (34.6%) were females. The incidence of large (≥10 mm in size) or giant aneurysms (≥25 mm in size) was 65.5%. Twenty-one (80.8%) patients underwent endovascular or surgical treatment and five (19.2%) received conservative treatment. Perioperative complications occurred in three patients, in whom two eventually recovered completely with a Glasgow Outcome Scale (GOS) score of 5 and one partially recovered with a GOS score 4. Overall, 25 (96.2%) patients had a favorable outcome and one (3.8%) had an unfavorable outcome at a mean follow-up of 22.8 months (range, 6–60 months).ConclusionPediatric IDAs are rare. In this series, endovascular management was a relatively safe and effective method of treatment for pediatric IDAs. However, continued follow-up is required because of the possibility of aneurysm recurrence and de novo aneurysm formation after treatment.

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“…Therefore, procedures such as parent-artery occlusion that promote mural thrombosis are often required for the treatment of dissecting aneurysms. However, dissecting aneurysms occasionally disappear because of progressive thrombosis of the aneurysmal sac or parent-artery lumen 2,21 . In adults, 18.3% of intracranial arterial dissections showed complete normalization between 15 days and two months following presentation with symptoms on neuroimaging follow-up, but these are non-ruptured cases 21 .…”

Section: Case Reportmentioning

confidence: 99%

Radiological Changes in Infantile Dissecting Anterior Communicating Artery Aneurysm Treated Endovascularly

et al. 2014

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Intracranial aneurysms are extremely rare in infants, and to our knowledge only seven infants treated for ruptured spontaneous dissecting aneurysms have been reported. Good outcomes have been achieved with endovascular treatment of infantile aneurysm. We the endovascular treatment of a one-month-old girl for ruptured dissecting aneurysm located in the anterior communicating artery, and the unique radiological changes that were observed during the perioperative and follow-up periods. These changes suggest that blood coagulation and fibrinolytic response play a part in the repair and healing processes of dissecting aneurysms. Careful neuroradiological surveys are needed for pediatric dissecting aneurysms treated endovascularly.

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Repair process in spontaneous intradural dissecting aneurysms in children: report of eight patients and review of the literature

Cited by 21 publications

References 20 publications

Intracranial Non-traumatic Aneurysms in Children and Adolescents

Intracranial Non-traumatic Aneurysms in Children and Adolescents

Treatment for Spontaneous Intracranial Dissecting Aneurysms in Childhood: A Retrospective Study of 26 Cases

Radiological Changes in Infantile Dissecting Anterior Communicating Artery Aneurysm Treated Endovascularly

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