Intracranial aneurysms in the pediatric population

Case series and literature review

Research output: Contribution to journalArticle

Abstract

Background: Intracranial aneurysms in children (≤18 years old) are rare, and their epidemiology is poorly understood. We present a prospective 14-year experience at our institution and review the literature to clarify the characteristics and outcomes of pediatric patients with intracranial aneurysms. Methods: Review of medical records in the Johns Hopkins aneurysm prospective database and review of the literature since 1939 were performed. Results: Of 1377 intracranial aneurysm cases at our institution from 1991 to 2004, 19 (1.4%) pediatric patients were treated using microsurgical or endovascular techniques. Male/female ratio was 2.2:1. Eleven percent occurred at the internal carotid artery (ICA) bifurcation, and 42% were located in the posterior circulation. Seven (37%) were giant lesions; 58% presented with subarachnoid hemorrhage. Patients in good Hunt and Hess grade (I-III) comprised 42%, and poor-grade (IV-V) patients comprised 16%. At a mean follow-up duration of 3.0 ± 3 years, 95% of patients demonstrated favorable outcomes with Glasgow Outcome Scale score of 4 or 5. In the literature, a total of 706 pediatric intracranial aneurysm cases have been described since 1939. The male/female ratio is 1.8:1. The ICA bifurcation was the location in 26%, and only 17% were in the posterior circulation. Twenty percent were giant lesions, and 80% presented with subarachnoid hemorrhage. Good- and poor-grade patients comprise 49% and 36% of the total cases, respectively. Favorable outcome was reported in 60%. Conclusions: During recent decades, good outcomes after the treatment of ruptured and unruptured pediatric aneurysms have increased, reaching 95% in the current series. Pediatric intracranial aneurysms occur more commonly in male patients and have a predilection for the terminal ICA bifurcation.

Original languageEnglish (US)
Pages (from-to)424-432
Number of pages9
JournalSurgical Neurology
Volume63
Issue number5
DOIs
StatePublished - May 2005

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Intracranial Aneurysm
Pediatrics
Internal Carotid Artery
Population
Subarachnoid Hemorrhage
Aneurysm
Glasgow Outcome Scale
Endovascular Procedures
Medical Records
Epidemiology
Databases

Keywords

  • Aneurysm
  • Intracranial
  • Pediatric
  • Review

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Intracranial aneurysms in the pediatric population : Case series and literature review. / Huang, Judy; McGirt, Matthew J.; Gailloud, Philippe; Tamargo, Rafael J.

In: Surgical Neurology, Vol. 63, No. 5, 05.2005, p. 424-432.

Research output: Contribution to journalArticle

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abstract = "Background: Intracranial aneurysms in children (≤18 years old) are rare, and their epidemiology is poorly understood. We present a prospective 14-year experience at our institution and review the literature to clarify the characteristics and outcomes of pediatric patients with intracranial aneurysms. Methods: Review of medical records in the Johns Hopkins aneurysm prospective database and review of the literature since 1939 were performed. Results: Of 1377 intracranial aneurysm cases at our institution from 1991 to 2004, 19 (1.4{\%}) pediatric patients were treated using microsurgical or endovascular techniques. Male/female ratio was 2.2:1. Eleven percent occurred at the internal carotid artery (ICA) bifurcation, and 42{\%} were located in the posterior circulation. Seven (37{\%}) were giant lesions; 58{\%} presented with subarachnoid hemorrhage. Patients in good Hunt and Hess grade (I-III) comprised 42{\%}, and poor-grade (IV-V) patients comprised 16{\%}. At a mean follow-up duration of 3.0 ± 3 years, 95{\%} of patients demonstrated favorable outcomes with Glasgow Outcome Scale score of 4 or 5. In the literature, a total of 706 pediatric intracranial aneurysm cases have been described since 1939. The male/female ratio is 1.8:1. The ICA bifurcation was the location in 26{\%}, and only 17{\%} were in the posterior circulation. Twenty percent were giant lesions, and 80{\%} presented with subarachnoid hemorrhage. Good- and poor-grade patients comprise 49{\%} and 36{\%} of the total cases, respectively. Favorable outcome was reported in 60{\%}. Conclusions: During recent decades, good outcomes after the treatment of ruptured and unruptured pediatric aneurysms have increased, reaching 95{\%} in the current series. Pediatric intracranial aneurysms occur more commonly in male patients and have a predilection for the terminal ICA bifurcation.",
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