The clinical features and treatment of pediatric intracranial aneurysm

Abstract

Purpose: Intracranial aneurysms are relatively rare in the pediatric population. The objective of this study was to highlight the clinical and radiological features and the therapeutic outcome and clarify the choice of therapeutic strategies for pediatric intracranial aneurysms.

Materials and methods: Twenty-four consecutive children (age <or=14 years) who were diagnosed and treated for intracranial aneurysms in our institute in the last 23 years were included in this study.

Results: There were nine (36%) patients with posterior circulation aneurysms and eight (32%) with giant aneurysms. Eleven (46%) patients presented with subarachnoid hemorrhage. Fifteen patients underwent endovascular treatment, and four received microsurgical therapy. Five patients were treated conservatively. Ninety-two percent (n=22) of the patients showed favorable outcomes.

Conclusions: Pediatric intracranial aneurysms differ in many ways from those in adults: male predominance; high incidence of giant, dissecting, and fusiform aneurysms; high incidence of aneurysms in the posterior circulation; high incidence of spontaneous thrombosis; better Hunt-Hess grades at presentation; and better therapeutic outcome. For children with intracranial aneurysms, both microsurgical approaches and endovascular treatment were effective. For many complex aneurysms, endovascular therapy was the best choice.