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Acta Neurochirurgica

, Volume 160, Issue 8, pp 1633–1642 | Cite as

Pediatric intracranial distal arterial aneurysms: report of 35 cases

  • Ruiqi Chen
  • Si Zhang
  • Rui Guo
  • Lu Ma
  • Chao You
Original Article - Pediatric Neurosurgery

Abstract

Background

Although research on pediatric intracranial aneurysms is well documented, studies of pediatric intracranial distal arterial aneurysms (PIDAAs) remain scarce.

Methods

All pediatric patients (≤ 18 years) with intracranial aneurysms located distally to the M2 segment of the middle cerebral artery (MCA), A2 segment of the anterior cerebral artery, P2 segment of the posterior cerebral artery, and other cerebral arteries distal to the main branch who were treated at our center between January 2012 and April 2017 were retrospectively reviewed.

Results

Thirty-five PIDAAs were observed in 35 patients with a mean age of 9.2 ± 5.9 years and a male ratio of 71.4% (n = 25). Sudden onset of severe headache was the most common symptom (n = 22, 62.9%), followed by seizures (n = 21, 60%). Twenty-seven patients (77.1%) had ruptured aneurysms, and 18 of them (66.7%) exhibited combined lobe intracerebral hematoma. MCA was the most common site (n = 23, 65.7%). Large or giant aneurysms were observed in 16 patients (45.7%). Eight patients (22.9%) had pseudoaneurysms, six of whom (75%) reported a head trauma history. Thirty patients (85.7%) had favorable outcomes at the end of the 6-month follow-up. Kaplan-Meier 6-month seizure curves revealed a significantly higher decrease in seizure rates in the surgical group than in the endovascular group (P = 0.036).

Conclusions

PIDAAs constitute a high proportion of pediatric intracranial aneurysms. PIDAAs are associated with an increased risk of seizures, a predilection for the MCA, and a high incidence of pseudoaneurysms with head trauma history. Surgical intervention is of greater benefit than endovascular treatment in controlling the risk of seizures.

Keywords

Pediatric patients Intracranial aneurysm Distal arterial aneurysms Seizure Surgical treatment Endovascular treatment 

Abbreviation

PIDAAs

Pediatric intracranial distal arterial aneurysms

MCA

Middle cerebral artery

IRB

Institutional Review Board

ACA

Anterior cerebral artery

PCA

Posterior cerebral artery

GCS

Glasgow Coma Score

LOS

Length of stay

CT

Computed tomography

CTA

Computed tomographic angiography

DSA

Digital subtraction angiography

mRS

Modified Rankin Scale

ICU

Intensive care unit

SD

Standard deviation

CI

Confidence intervals

PICA

Posterior inferior cerebellar artery

Notes

Funding

This study was funded by the Fundamental Research Funds for the Central Universities (2012017yjsy200).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

For this type of study, formal consent is not required.

Informed consent

Informed consent was obtained from the parents or legal guardians of all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Neurosurgery, West China HospitalSichuan UniversityChengduChina

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