Abstract
Introduction
The purpose of this study is to report the characteristics and outcomes of pediatric patients with intracranial aneurysms.
Methods
From 1998 to 2005, 25 pediatric patients (aged ≤17 years) with intracranial aneurysm were treated at our institute. Eleven of 25 patients had subarachnoid hemorrhage. In ten patients, the aneurysm was an incidental finding. One patient presented with cranial nerves dysfunction and three with neurological deficits. The locations of the aneurysms were as follows: vertebral artery (VA; n = 9), middle cerebral artery (MCA; n = 5), posterior cerebral artery (PCA; n = 4), basilar artery (BA; n = 2), anterior communicating artery (n = 2), anterior cerebral artery (n = 2), and internal carotid artery (n = 1).
Results
Five patients were treated with selective embolization with coils. Sixteen patients were treated with parent vessel occlusion (PVO). Eight PVOs were performed with balloons and eight were performed with coils. One patient with a VA aneurysm was spontaneously thrombosed 4 days after the initial diagnostic angiogram. In three patients treated with stent alone or stent-assisted coiling, one with BA trunk aneurysm died. One aneurismal recurrence occurred and was retreated. At a mean follow-up duration of 23.5 months, 96% of patients had a Glasgow Outcome Scale score of 4 or 5.
Conclusions
Pediatric intracranial aneurysms occur more commonly in male patients and have a predilection for the VA, PCA, and MCA. PVO is an effective and safe treatment for fusiform aneurysms. Basilar trunk fusiform aneurysms were difficult to treat and were associated with a high mortality rate.
Similar content being viewed by others
References
Huang J, McGirt MJ, Gailloud P, Tamargo RJ (2005) Intracranial aneurysms in the pediatric population: case series and literature review. Surg Neurol 63:424–433
Liang J, Bao Y, Zhang H, Wrede KH, Zhi X, Li M, Ling F (2008) The clinical features and treatment of pediatric intracranial aneurysm. Childs Nerv Syst 25:317–324
Sharma BS, Gupta A, Ahmad FU, Suri A, Mehta VS (2008) Surgical management of giant intracranial aneurysms. Clin Neurol Neurosurg 110(7):674–681
Vaid VK, Kumar R, Kalra SK, Mahapatra AK, Jain VK (2008) Pediatric intracranial aneurysms: an institutional experience. Pediatr Neurosurg 44(4):296–301
Lv X, Li Y, Wu Z (2008) Endovascular management for bilateral ophthalmic segment “kissing aneurysms” presenting with nasal bleeding: case report. Neuroradiol J 21:266–269
Lv X, Li Y, Liu A, Zhang J, Wu Z (2008) Parent artery occlusion for peripheral anterior inferior cerebellar artery aneurysm: case report and review of the literature. Neuroradiol J 21:261–265
Lv X, Li Y, Jiang C, Yang X, Wu Z (2009) Parent vessel occlusion for P2 dissecting aneurysms of the posterior cerebral artery. Surg Neurol 71(3):319–325
Lv X, Li Y, Liu A, Jiang P, Lv M, Wu Z (2007) Endovascular treatment of intracranial giant serpentine aneurysms. Neuroradiol J 20(2):237–241
Andreou A, Ioannidis I, Mitsos A (2007) Endovascular treatment of peripheral intracranial aneurysms. AJNR Am J Neuroradiol 28:355–361
Grosso S, Mostardini R, Venturi C, Bracco S, Casasco A, Berardi R, Balestri P (2002) Recurrent torticollis caused by dissecting vertebral artery aneurysm in a pediatric patient: results of endovascular treatment by use of coil embolization: Case report. Neurosurgery 50:204–208
Zhang YJ, Barrow DL, Day AL (2002) Extracranial–intracranial vein graft bypass for giant intracranial aneurysm surgery for pediatric patients: Two technical case reports. Neurosurgery 50:663–668
Aryan HE, Giannotta SL, Fukushima T, Park MS, Ozgur BM, Levy ML (2006) Aneurysms in children: review of 15 years experience. J Clin Neurosci 13:188–192
Meyer FB, Sundt TM, Node NC (1989) Cerebral aneurysms in childhood and adolescence. J Neurosurg 70:420–425
Stiefel MF, Heuer GG, Basil AK, Weigele JB, Sutton LN, Hurst RW, Storm PB (2008) Endovascular and surgical treatment of ruptured cerebral aneurysms in pediatric patients. Neurosurgery 63:859–866
Agid R, Souza MPS, Reintamm G, Armstrong D, Dirks P, terBrugge KG (2005) The role of endovascular treatment for pediatric aneurysms. Childs Nerv Syst 21(12):1030–1036
Lasjaunias P, Wuppalapati S, Alvarez H, Rodesch G, Ozanne A (2005) Intracranial aneurysms in children aged under 15 years: review of 59 consecutive children with 75 aneurysms. Childs Nerv Syst 21(6):437–450
Conflict of interest statement
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lv, X., Jiang, C., Li, Y. et al. Endovascular treatment for pediatric intracranial aneurysms. Neuroradiology 51, 749–754 (2009). https://doi.org/10.1007/s00234-009-0553-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00234-009-0553-4