Pediatric intracranial aneurysms in Senegal: a series of 10 cases treated in unfavorable socio-economic conditions

Thioub, Mbaye; Mbaye, Modou; Thiam, Alioune Badara; Mutomb, Sarah; Sy, Cheikh; Faye, M.; Ba, Momar Codé; Badiane, S

doi:10.1007/s00381-018-3943-2

Cited by 12 publications

(8 citation statements)

References 17 publications

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“…Middle cerebral artery (MCA) aneurysms and posterior communicating artery (PCOM) aneurysms are also less commonly found than adult 16 . But, multiple aneurysms are twice as more common in pediatric group than in adults 27 . In our series we found 12.5% of our patients having multiple IAs.…”

Section: Discussionmentioning

confidence: 98%

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Endovascular Managent of Supra and Infra Tentorial Pediatric Intracranial Aneurysms: A Single Center Experience

Purkayastha

NATH

MOHAMMAD

et al. 2022

Preprint

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Intracranial aneurysms are rare in pediatric population. They have different pathophysiology, location, type, outcome than adults. Long life expectancy, denovo occurrence and their tendency to recur necessitate the long term follow up in these cases. Here we summarize our experience in treating these aneurysms in a tertiary care hospital from 2014 to 2021. We found 4% of our total aneurysm population to be under 18 years with a male to female ratio of 1.5:1. 13.3% patients had multiple aneurysms and 38.9% had posterior circulation aneurysms. Most common site of aneurysm was ICA bifurcation. Most of the patients were treated endovascularly with favorable outcome at follow up.

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Section: Discussionmentioning

confidence: 98%

“…Vasospasm is probably the commonest complication with rates from 9 to 53% 7 . But it is probably more tolerated in children than in adults due to more collateral and great neuroplasticity 7,27 .…”

Section: Recurrence and Complicationsmentioning

confidence: 99%

Endovascular Managent of Supra and Infra Tentorial Pediatric Intracranial Aneurysms: A Single Center Experience

Purkayastha

NATH

MOHAMMAD

et al. 2022

Preprint

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“…In other circumstances, neurosurgeons are forced to lean on one modality, for example, microsurgery due to the lack of adequate imaging equipment to explore the possibility of endovascular treatment. We offered microsurgery to our patients because of our experience with open surgery, lower cost to the patient, and its long-term benefit [33]. Other important factors, often not considered, involve parents’ decisions and the medical facility’s autonomy.…”

Section: Discussionmentioning

confidence: 99%

The Burden of Pediatric Subarachnoid Hemorrhage Healthcare Disparities in Senegal: A Retrospective Cohort Study

Thioub

Mbaye

Zolo³

et al. 2021

Pediatr Neurosurg

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Introduction Pediatric aneurysms are uncommon but potentially deadly clinical conditions with varied etiology and outcomes. In low-resource countries, numerous barriers prevent the timely diagnosis and management of pediatric aneurysmal subarachnoid hemorrhage (aSAH). Thus, this study aimed to assess the mortality of pediatric aSAH stemming from limited access to pediatric neurological surgery care in Senegal. Methods Pediatric aSAH patients admitted at the authors’ institution from 2012 and 2020 were recruited. Spearman Rho’s correlation, McNemar’s test, and Wilcoxon signed-rank test were used. Odds ratios and their 95% confidence intervals were calculated, and the population attributable fraction (PAF) was used to quantify aSAH mortality attributable to lack of surgical care. Results Twenty-four pediatric patients (12 females and 12 males) aged 12.2 (95% CI=10.0-14.3) years presented with aSAH. They had 1 median aneurysm (range [1, 2]) measuring 12.6 (6.1-19.0) mm. The median WFNS grade was 3 (range [1, 4]), and the mean Fisher grade was 4 (range [1, 4]). Fifteen patients (62.5%) had surgical treatment on day 15.0 (IQR=23.0) of hospitalization. The overall mortality rate was 20.8%, and the PAF of mortality for lack of surgical treatment during hospitalization was 0.08. Conclusion Eight percent of deaths among pediatric aSAH patients who do not receive surgical treatment are attributable to lack of access to surgical treatment. Health systems strengthening policies should be implemented to address this health inequity.

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“…Also, one aneurysm was of traumatic origin and four with possible infectious origin. The authors recommend clipping when socioeconomic conditions are unfavorable 20 . Ilovar et al treated eight patients with cerebral aneurysms: one underwent clipping, four underwent NET, and three were managed conservatively (two incidental and one symptomatic), concluding that endovascular and microsurgical management are similar 21 .…”

Section: Ethical Disclosuresmentioning

confidence: 99%

Cerebral aneurysms in pediatrics: a case report and review of the literature

Heredia-Gutiérrez¹,

Carbarín-Carbarín²

2021

BMHIM

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Background: Cerebral aneurysms in pediatrics represent < 4% of the total of this condition, and their rupture represents 10-23% mortality. Aneurysms have been associated with infections, head injuries, sickle cell anemia, cardiovascular diseases, autoimmune diseases, immunodeficiencies, and connective tissue diseases. Their clinical presentation includes severe headache, seizures, motor-sensory deficits, and death due to subarachnoid and intraparenchymal hemorrhage. Case report: We describe the case of a 12-year-old female patient who presented with a sudden intense headache; after 72 hours, generalized tonic-clonic seizures were observed. At the hospital, she was stabilized with antiepileptic drugs and analgesics. A simple head computed tomography scan showed intraparenchymal hemorrhage in the right frontal lobe and subarachnoid hemorrhage. The study was complemented with a cerebral angiotomography, which revealed an aneurysm of the anterior communicating artery. The pediatric neurosurgeon evaluated the case, and management in the pediatric intensive care unit was decided. Two weeks after the stroke, the aneurysm was clipped and excluded. The patient developed adequate clinical evolution and resolution of initial symptoms, resuming her daily activities. Conclusions: Pediatric cerebral aneurysms differ from their adult counterparts, mainly in their etiology and evolution. In addition, pediatric patients have a longer life expectancy. Aneurysm clipping and neurological endovascular therapy have shown similar results.

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Pediatric intracranial aneurysms in Senegal: a series of 10 cases treated in unfavorable socio-economic conditions

Abstract: In Senegal, pediatric aneurysms represent about 8.3% of all intracranial aneurysms. They are most often located on the MCA and have commonly fusiform shape. Despite difficult treatment conditions, overall outcome was good.

Cited by 12 publications

References 17 publications

Endovascular Managent of Supra and Infra Tentorial Pediatric Intracranial Aneurysms: A Single Center Experience

Endovascular Managent of Supra and Infra Tentorial Pediatric Intracranial Aneurysms: A Single Center Experience

The Burden of Pediatric Subarachnoid Hemorrhage Healthcare Disparities in Senegal: A Retrospective Cohort Study

Cerebral aneurysms in pediatrics: a case report and review of the literature

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