Unruptured intracranial aneurysms in children with sickle cell disease: Analysis of 18 aneurysms in 5 patients

Surbhi Saini, Barbara Speller-Brown, Emily Wyse, Emily R. Meier, Jessica Carpenter, Ross M. Fasano, Monica S. Pearl

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Intracranial aneurysms (IAs) are rare in the general pediatric population and account for <2% of all cerebral aneurysms. Only 7 children with sickle hemoglobinopathy and IAs have been reported, the majority of which were discovered after rupture. OBJECTIVE: To report the prevalence of unruptured IAs in a selected population of children with sickle cell disease (SCD) and to describe the aneurysm morphology, hematologic characteristics, and management in this patient population. METHODS: A retrospective review of the electronic database for all children with SCD who underwent brain magnetic resonance imaging or angiography from January 2002 to August 2013 at a single institution was performed. Records were reviewed for IA, age, sex, sickle cell genotype, neurological symptoms, hematologic indexes, transcranial Doppler findings, and management. RESULTS: Five of 179 children (2.8%) with SCD imaged by brain magnetic resonance imaging or angiography were diagnosed with IAs. None presented with subarachnoid hemorrhage. Four patients (80%) had HbSS disease, and 1 patient had hemoglobin sickle cell HbSC disease. A total of 18 aneurysms were detected; the majority of patients had multiple aneurysms (80%) and bilateral involvement (60%). CONCLUSION: Children with SCD are at risk for developing multiple intracranial aneurysms, and a high index of suspicion must be maintained during the interpretation of routine magnetic resonance imaging or angiography of the brain.

Original languageEnglish (US)
Pages (from-to)531-539
Number of pages9
JournalNeurosurgery
Volume76
Issue number5
DOIs
StatePublished - May 21 2015

Keywords

  • Intracranial aneurysm
  • Pediatrics
  • Sickle cell anemia

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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