Pediatric Intracranial Aneurysms: Favorable Outcomes despite Rareness and Complexity.

Pediatric Intracranial Aneurysms: Favorable Outcomes despite Rareness and Complexity.

World Neurosurg. 2019 Feb 19;:

Authors: Kim M, Lee HS, Lee S, Park JC, Ahn JS, Kwon DH, Kwun BD, Park W

Abstract
OBJECTIVE: Pediatric intracranial aneurysms (IAs) are rare and differ from their adult counterparts in terms of their aneurysmal characteristics, presentation, treatment, and outcomes. Their treatment is often more difficult and complex compared to adults. However, studies outlining the clinical impact of pediatric IAs remain sparse.
METHODS: We retrospectively reviewed patients (≤ 18 years old) admitted to our hospital between 2000 and 2017 and diagnosed with IAs.
RESULTS: From the sample of 8207 patients with IA diagnosis, 26 patients with 33 IAs were involved. Our cohorts consisted of 17 males and 9 females with a mean age of 12.5 years. The mean follow-up duration was 4 years and 3 months. Seven patients (26.92%) were assumed to have traumatic origin of their IAs. Ruptured aneurysms were more common than unruptured ones (61.53% vs. 38.46%). Complex features were observed in 14 aneurysms (42.42%). Initially, microsurgical and endovascular treatment were both performed in 10 patients (38.46%). Good recovery was obtained in 16 patients (61.54%) based on Glasgow outcome scores at 6-month follow-ups. Complete obliteration of aneurysms was observed in 17 patients (65.38%). Endovascular treatment was the initial treatment in 3 patients with incomplete obliteration.
CONCLUSIONS: Treatment of pediatric IAs is challenging and technically demanding due to their discrete nature compare to adult and the need for greater surgical skills. There was a male predominance with internal carotid artery bifurcation as the most frequent location of the aneurysms. Despite higher incidence of ruptured and complex aneurysm cases, many patients experienced good recovery on six-month follow-up.

PMID: 30794975 [PubMed - as supplied by publisher]

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