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Pediatric intracranial aneurysms—our experience and review of literature

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Abstract

Purpose

Intracranial aneurysms in children are not as common as in adults and there are many differences in the etiology, demographic variables, aneurysm location, aneurysm morphological characteristics, clinical presentation, and outcome in pediatric and adult intracranial aneurysms.

Methods

All children (≤18 years) suffering from intracranial aneurysm managed at our center from July 2001 through June 2013 were included in the study, and the details of these patients were retrieved from the computerized database of our hospital.

Observations

A total of 62 pediatric patients were treated for 74 aneurysms during the study period and constituted 2.3 % of all intracranial aneurysms treated during the same period. The mean age at presentation was 13.5 years. Headache (82 %) was the commonest presenting feature; other symptoms included seizures (21 %), ictal loss of consciousness (27 %), and motor/cranial nerve deficits (22.6 %). Computed tomogram revealed subarachnoid hemorrhage in 58 % of patients. Eighty-two percent of aneurysms were in anterior circulation. Sixty-seven percent of aneurysms were complex aneurysms. Fifty-eight percent of patients underwent surgical intervention while 30 % underwent endovascular procedures. Twenty-one percent of the patients developed vasospasm. There was no postoperative mortality. Favorable outcome was seen in 72 % of the patients.

Conclusions

Pediatric intracranial aneurysms are uncommon as compared to in adult patients. Seizures and cranial nerve involvement are seen more often as the presenting features in children. Posterior circulation aneurysms are more common in children, as are the internal carotid artery bifurcation aneurysms. There is high incidence of giant, posttraumatic, and mycotic aneurysms in children.

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References

  1. Allison JW, Davis PC, Sato Y, James CA, Haque SS, Angtuaco EJ, Glasier CM (1998) Intracranial aneurysms in infants and children. Pediatr Radiol 28:223–229

    Article  CAS  PubMed  Google Scholar 

  2. Almeida GM, Pindaro J, Plese P, Bianco E, Shibata MK (1977) Intracranial arterial aneurysms in infancy and childhood. Childs Brain 3:193–199

    CAS  PubMed  Google Scholar 

  3. Amacher LA, Drake CG (1975) Cerebral artery aneurysms in infancy, childhood and adolescence. Childs Brain 1:72–80

    CAS  PubMed  Google Scholar 

  4. 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

    Article  PubMed  Google Scholar 

  5. Aspoas AR, de Villiers JC (1993) Bacterial intracranial aneurysms. Br J Neurosurg 7:367–376

    Article  CAS  PubMed  Google Scholar 

  6. Ferrante L, Fortuna A, Celli P, Santoro A, Fraioli B (1988) Intracranial arterial aneurysms in early childhood. Surg Neurol 29:39–56

    Article  CAS  PubMed  Google Scholar 

  7. Gerosa M, Licata C, Fiore DL, Iraci G (1980) Intracranial aneurysms of childhood. Childs Brain 6:295–302

    CAS  PubMed  Google Scholar 

  8. Herman JM, Rekate HL, Spetzler RF (1991) Pediatric intracranial aneurysms: simple and complex cases. Pediatr Neurosurg 17:66–72, discussion 73

    Article  PubMed  Google Scholar 

  9. Hetts SW, Narvid J, Sanai N, Lawton MT, Gupta N, Fullerton HJ, Dowd CF, Higashida RT, Halbach VV (2009) Intracranial aneurysms in childhood: 27-year single-institution experience. AJNR Am J Neuroradiol 30:1315–1324

    Article  CAS  PubMed  Google Scholar 

  10. Huang J, McGirt MJ, Gailloud P, Tamargo RJ (2005) Intracranial aneurysms in the pediatric population: case series and literature review. Surg Neurol 63:424–432, discussion 432-423

    Article  PubMed  Google Scholar 

  11. Hunt WE, Hess RM (1968) Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg 28:14–20

    Article  CAS  PubMed  Google Scholar 

  12. Jennett B, Bond M (1975) Assessment of outcome after severe brain damage. Lancet 1:480–484

    Article  CAS  PubMed  Google Scholar 

  13. Jian BJ, Hetts SW, Lawton MT, Gupta N (2010) Pediatric intracranial aneurysms. Neurosurg Clin N Am 21:491–501

    Article  PubMed  Google Scholar 

  14. Jordan LC, Johnston SC, Wu YW, Sidney S, Fullerton HJ (2009) The importance of cerebral aneurysms in childhood hemorrhagic stroke: a population-based study. Stroke 40:400–405

    Article  PubMed Central  PubMed  Google Scholar 

  15. Kakarla UK, Beres EJ, Ponce FA, Chang SW, Deshmukh VR, Bambakidis NC, Zabramski JM, Spetzler RF (2010) Microsurgical treatment of pediatric intracranial aneurysms: long-term angiographic and clinical outcomes. Neurosurgery 67:237–249, discussion 250

    Article  PubMed  Google Scholar 

  16. Koroknay-Pal P, Lehto H, Niemela M, Kivisaari R, Hernesniemi J (2012) Long-term outcome of 114 children with cerebral aneurysms. J Neurosurg Pediatr 9:636–645

    Article  PubMed  Google Scholar 

  17. Koroknay-Pal P, Niemela M, Lehto H, Kivisaari R, Numminen J, Laakso A, Hernesniemi J (2013) De novo and recurrent aneurysms in pediatric patients with cerebral aneurysms. Stroke 44:1436–1439

    Article  PubMed  Google Scholar 

  18. Krishna H, Wani AA, Behari S, Banerji D, Chhabra DK, Jain VK (2005) Intracranial aneurysms in patients 18 years of age or under, are they different from aneurysms in adult population? Acta Neurochir (Wien) 147:469–476, discussion 476

    Article  CAS  Google Scholar 

  19. Larson PS, Reisner A, Morassutti DJ, Abdulhadi B, Harpring JE (2000) Traumatic intracranial aneurysms. Neurosurg Focus 8:e4

    Article  CAS  PubMed  Google Scholar 

  20. 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 21:437–450

    Article  PubMed  Google Scholar 

  21. Mehrotra A, Nair AP, Das KK, Srivastava A, Sahu RN, Kumar R (2012) Clinical and radiological profiles and outcomes in pediatric patients with intracranial aneurysms. J Neurosurg Pediatr 10:340–346

    Article  PubMed  Google Scholar 

  22. Meyer FB, Sundt TM Jr, Fode NC, Morgan MK, Forbes GS, Mellinger JF (1989) Cerebral aneurysms in childhood and adolescence. J Neurosurg 70:420–425

    Article  CAS  PubMed  Google Scholar 

  23. Muszynski CA, Carpenter RJ Jr, Armstrong DL (1994) Prenatal sonographic detection of basilar aneurysm. Pediatr Neurol 10:70–72

    Article  CAS  PubMed  Google Scholar 

  24. Ostergaard JR (1991) Aetiology of intracranial saccular aneurysms in childhood. Br J Neurosurg 5:575–580

    Article  CAS  PubMed  Google Scholar 

  25. Proust F, Toussaint P, Garnieri J, Hannequin D, Legars D, Houtteville JP, Freger P (2001) Pediatric cerebral aneurysms. J Neurosurg 94:733–739

    Article  CAS  PubMed  Google Scholar 

  26. Roche JL, Choux M, Czorny A, Dhellemmes P, Fast M, Frerebeau P, Lapras C, Sautreaux JL (1988) Intracranial arterial aneurysm in children. A cooperative study. Apropos of 43 cases. Neurochirurgie 34:243–251

    CAS  PubMed  Google Scholar 

  27. Sanai N, Quinones-Hinojosa A, Gupta NM, Perry V, Sun PP, Wilson CB, Lawton MT (2006) Pediatric intracranial aneurysms: durability of treatment following microsurgical and endovascular management. J Neurosurg 104:82–89

    PubMed  Google Scholar 

  28. Saraf R, Shrivastava M, Siddhartha W, Limaye U (2012) Intracranial pediatric aneurysms: endovascular treatment and its outcome. J Neurosurg Pediatr 10:230–240

    Article  PubMed  Google Scholar 

  29. Sharma BS, Sinha S, Mehta VS, Suri A, Gupta A, Mahapatra AK (2007) Pediatric intracranial aneurysms—clinical characteristics and outcome of surgical treatment. Childs Nerv Syst 23:327–333

    Article  CAS  PubMed  Google Scholar 

  30. Vasan R, Patel J, Sweeney JM, Carpenter AM, Downes K, Youssef AS, van Loveren H, Agazzi S (2013) Pediatric intracranial aneurysms: current national trends in patient management and treatment. Childs Nerv Syst 29:451–456

    Article  PubMed  Google Scholar 

  31. Ventureyra EC, Higgins MJ (1994) Traumatic intracranial aneurysms in childhood and adolescence. Case reports and review of the literature. Childs Nerv Syst 10:361–379

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

The authors have no personal financial or institutional interest in any of the drugs, materials, or devices described in this article. The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Portion of this work was presented as proceedings at the 40th International Society of Pediatric Neurosurgery conference 2012, Sydney, Australia (September, 2012) and abstract is published in Child's Nervous System, September 2012 issue.

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Authors and Affiliations

  1. Department of Neurosurgery, Cardio-Neuro Centre, All India Institute of Medical Sciences, Room No 720, New Delhi, India

    Kanwaljeet Garg, Pankaj Kumar Singh, Bhawani Shankar Sharma, Poodipedi Sarat Chandra, Ashish Suri, Manmohanjit Singh, Rajinder Kumar, Shashank Sarad Kale, Nalin Kumar Mishra & Shailesh K Gaikwad

  2. All India Institute of Medical Sciences, Bhubaneshwar, India

    Ashok Kumar Mahapatra

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  1. Kanwaljeet Garg
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  2. Pankaj Kumar Singh
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Correspondence to Pankaj Kumar Singh.

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Garg, K., Singh, P.K., Sharma, B.S. et al. Pediatric intracranial aneurysms—our experience and review of literature. Childs Nerv Syst 30, 873–883 (2014). https://doi.org/10.1007/s00381-013-2336-9

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