Surgically Managed Pediatric Intracranial Aneurysms: How Different Are They from Adult Intracranial Aneurysms?

Deora, Harsh; Rao, K.V.L. Narasinga; Somanna, Sampath; Srinivas, Dwarakanath; Shukla, Dhaval; Bhat, Dhananjaya I

doi:10.1159/000477815

Cited by 17 publications

(13 citation statements)

References 33 publications

(69 reference statements)

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“…Brain aneurysms affect almost exclusively the adult population [1], and its incidence in children is rare [1][2][3][4][5][6][7][8][9][10], accounting for less than 5% of all aneurysms [1-3, 5, 7, 8, 11, 12]. Also, compared to adults, they are more complex [4,10] and differ in location, morphological characteristics, the presentation, and outcome [7,8].…”

Section: Introductionmentioning

confidence: 99%

Intracranial Aneurysm in Pediatric Population: A Single-Center Experience

et al. 2022

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Purpose: Pediatric intracranial aneurysms (PIA) are rarer and more complex when compared to adult aneurysms. In general, the clinical presentation of PIA is due to a mass effect, but the presenting symptoms can be also related to ischemia, subarachnoid hemorrhage (SAH) or in a combination of different symptoms. This paper aims to report a single-center experience with clinical and angiographic aspects of brain aneurysm in children. Methods: We retrospectively reviewed our prospectively maintained database for patients with intracranial aneurysms in our institution from July 2015 to February 2021. Among these, all patients under 18 years-old submitted to a diagnostic or therapeutic procedure for an intracranial aneurysm were included. Results: Twelve patients were submitted to diagnostic or therapeutic procedures in our department. Three of them had multiple aneurysms, and in total, 17 intracranial aneurysms were assessed in this study. The most frequent location was in the middle cerebral artery (seven cases / 41%). Five out of twelve children (42%) presented SAH due to ruptured aneurysm. Three patients (25%) had symptoms due to the mass effect from large aneurysms, with compression of cranial nerves or brainstem. Aneurysms diameters ranged from 1.5 mm to 34 mm (mean 14.2 mm), with six aneurysms being giant and eight being non-saccular/fusiform. Twelve aneurysms were submitted to endovascular treatment, with one treatment-related clinical complication and later death. Conclusion: Pediatric intracranial aneurysms are rare diseases that can arise from a variety of different underlying pathological mechanisms. The management of these conditions requires a detailed understanding of the pathology and a multi-disciplinary approach. Despite the availability of new technologies, parent vessel occlusion remains a valid option for aneurysms in the pediatric population.

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Section: Introductionmentioning

confidence: 99%

Intracranial Aneurysm in Pediatric Population: A Single-Center Experience

et al. 2022

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“…Undiagnosed patients with un-ruptured intracerebral aneurysms can present with a neurological or neuropsychiatric illness like a migraine without aura, focal and generalized seizures, frontal lobe syndrome, and visual impairment [6]. Intracranial internal carotid artery aneurysm may present with diplopia, retroorbital pain, and unilateral headache mimicking migraine without aura.…”

Section: Discussionmentioning

confidence: 99%

Fourteen-Year-Old Boy With Intracranial Internal Carotid Artery Aneurysm Presenting as Mood Disorder

Madhusankha¹,

Rathnayaka²,

Samaranayake³

et al. 2021

Cureus

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Intracranial aneurysms (IA) are very uncommon to find in the pediatric population. If present, it is usually associated with other genetic illnesses. Most of the intracranial aneurysm has been presented due to mass effect of the aneurysm or as subarachnoid hemorrhage. We report this young Asian kid who has had a possible ictus of subarachnoid hemorrhage (SAH) with depressive symptoms, later presenting with classic features of SAH due to rupture of intracranial internal carotid artery aneurysm. The use of Sertraline to treat depressive episodes may aggregate the condition due to its antiplatelet effect. The patient showed significant improvement following microsurgical clipping of the aneurysm. This case is another example that young patients coming with the first episode of mood disorder should be carefully excluded for other intracranial pathology, including intracranial aneurysms, before coming to the final diagnosis.

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“…Ruptured aneurysms present with subarachnoidal hemorrhage (SAH) and intracerebral/intraventricular or subdural hemorrhage. SAH is by far the most common symptom in the majority of pediatric intracranial aneurysm case series [2-9]. In recent clinical reviews by Sorteberg and Dahlberg [1], Regelsberger et al [10], and Huang et al [11], the average SAH presentation rates were reported as 72, 77, and 80%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Acute Obstructive Hydrocephalus due to a Giant Posterior Cerebral Artery Aneurysm in a Pediatric Patient

et al. 2018

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Introduction: Intracranial aneurysms are very rare in children. Although subarachnoidal hemorrhage (SAH) is by far the most common presentation of aneurysms in the majority of the pediatric case series, it is not rare for an unruptured aneurysm to present with a mass effect. Acute hydrocephalus is a common finding following aneurysmal SAH. However, this malady may develop even in the absence of SAH but secondary to direct obstruction by a giant aneurysm. This situation is extremely rare in children, with only a few known case reports in the literature. Case Report: We report the case of a 10-year-old girl who presented with signs and symptoms of acute hydrocephalus; further radiological evaluation revealed obstructive hydrocephalus and a giant posterior cerebral artery aneurysm. Following endovascular treatment of the aneurysm, hydrocephalus was completely resolved, and the patient was symptom free. Conclusion: Although they are very rare, giant intracranial aneurysms must be kept in mind during the differential diagnosis of pediatric acute hydrocephalus cases. Hydrocephalus may resolve spontaneously after the successful treatment of these aneurysms.

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Surgically Managed Pediatric Intracranial Aneurysms: How Different Are They from Adult Intracranial Aneurysms?

Cited by 17 publications

References 33 publications

Intracranial Aneurysm in Pediatric Population: A Single-Center Experience

Intracranial Aneurysm in Pediatric Population: A Single-Center Experience

Fourteen-Year-Old Boy With Intracranial Internal Carotid Artery Aneurysm Presenting as Mood Disorder

Acute Obstructive Hydrocephalus due to a Giant Posterior Cerebral Artery Aneurysm in a Pediatric Patient

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