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Management of ruptured dissecting intracranial aneurysms in infants: report of four cases and review of the literature

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Abstract

Backgound

Intracranial cerebral aneurysms in the pediatric population are infrequent, and those occurring in infants less than 1 year old are extremely rare. Of intracranial aneurysms in children, dissecting aneurysms are the most common type seen. While spontaneous dissecting aneurysms usually present with ischemia, hemorrhage can also occur.

Methods

A retrospective review of our patients revealed that from July 1, 2007 to June 30, 2012, four infants were treated for ruptured distal dissecting intracranial aneurysms at Texas Children’s Hospital. Mycotic aneurysms and collagen vascular disorder were excluded in all four cases. All patients presented in our series presented with subarachnoid hemorrhage, and three had intraventricular hemorrhage. All patients underwent conventional catheter angiography for diagnosis. All patients in this series were managed in the acute or subacute period with surgical or endovascular trapping without distal bypass procedures. All four patients tolerated sacrifice of the parent vessels feeding these distal aneurysms well.

Case report and review of literature

We describe the presentation and management of these rare cases and then review the current literature on the management of these dissecting aneurysms in infants.

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Authors and Affiliations

  1. Division of Pediatric Neurosurgery, Texas Children’s Hospital, 6621 Fannin Street, CCC 1230.01, 12th Floor, Houston, TX, 77030, USA

    Vikas Y. Rao, Krishna B. Shah, Robert J. Bollo, William E. Whitehead, Daniel J. Curry, Robert C. Dauser, Thomas G. Luerssen & Andrew Jea

  2. Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA

    Vikas Y. Rao, Krishna B. Shah, Robert J. Bollo, William E. Whitehead, Daniel J. Curry, Robert C. Dauser, Thomas G. Luerssen & Andrew Jea

  3. Division of Neurointerventional Radiology, Texas Children’s Hospital, Houston, TX, USA

    Michel E. Mawad

  4. Department of Radiology, Baylor College of Medicine, Houston, TX, USA

    Michel E. Mawad

Authors
  1. Vikas Y. Rao
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  2. Krishna B. Shah
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  3. Robert J. Bollo
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  4. Michel E. Mawad
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  5. William E. Whitehead
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  6. Daniel J. Curry
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  7. Robert C. Dauser
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  8. Thomas G. Luerssen
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  9. Andrew Jea
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Corresponding author

Correspondence to Andrew Jea.

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Rao, V.Y., Shah, K.B., Bollo, R.J. et al. Management of ruptured dissecting intracranial aneurysms in infants: report of four cases and review of the literature. Childs Nerv Syst 29, 685–691 (2013). https://doi.org/10.1007/s00381-012-1924-4

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  • DOI: https://doi.org/10.1007/s00381-012-1924-4

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