Intracranial aneurysms in children aged under 15 years: review of 59 consecutive children with 75 aneurysms

Abstract

The multiple etiologies encountered confirm the heterogenous nature of "aneurysms". The variety of treatments used suggests the need to categorise aneurysms into subgroups in sufficient numbers to fully appreciate the behavior of the lesions and make the appropriate therapeutic decisions.

Pediatric Intracranial Aneurysms: New and Enlarging Aneurysms after Index Aneurysm Treatment or Observation

“…It has been posited that many morphologically fusiform aneurysms represent dissecting aneurysms in which thrombus is present between layers of the arterial wall in addition to intraluminal thrombus forming at sites of slow flow in the dilated arterial lumen. 23 Patient 1 of our series demonstrates a fusiform aneurysm morphology with either intraluminal or mural thrombus in the distal portion of a PCA aneurysm that persisted after successful occlusion of the more proximal portion of the aneurysm (thus, the parent PCA). The development of a new PCA aneurysm proximally adjacent to but apparently separate from the initially treated aneurysm raises 2 possibilities.…”

Treatment of cerebral aneurysms in children: analysis of the Kids' Inpatient Database

“…18,19,26 Aneurysms in children are different from those in adults in several aspects; they are more common in males, with a male to female ratio of almost 3:1, and they tend to be larger, with a higher incidence of giant aneurysms in children compared with adults. [13][14][15]25 Because of the latter difference, aneurysms in children may present with nonhemorrhagic symptoms such as mass effect, headaches, focal neurological deficits, and seizures. The risk of rupture of these aneurysms varied in the literature between 22% and 100% depending on the origin, including dissection, trauma, and infection.…”

Radiological Changes in Infantile Dissecting Anterior Communicating Artery Aneurysm Treated Endovascularly

“…In adults, 18.3% of intracranial arterial dissections showed complete normalization between 15 days and two months following presentation with symptoms on neuroimaging follow-up, but these are non-ruptured cases 21 . Spontaneous thrombosis of a pediatric dissecting aneurysm is not uncommon; 13.6% of dissecting aneurysms undergo spontaneous complete thrombosis and require no further treatment 1 . Certainly intracranial arterial dissection frequently causes severe problems, but most dissecting lesions will be thrombosed sometime during their repair and healing process regardless of whether they were treated or not 21 .…”

“…Less than 2% of all childhood aneurysms occur during infancy 8 , and the incidence of ruptured aneurysms in infants is extremely low. The location and morphology as well as the clinical and radiological features of pediatric cases differ from those of adult cases 1,9 .…”

“…Intracranial aneurysms are uncommon in children, accounting for only 0.17-6.8% of all intracranial aneurysm cases [1][2][3][4][5][6][7] . Less than 2% of all childhood aneurysms occur during infancy 8 , and the incidence of ruptured aneurysms in infants is extremely low.…”