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Pediatric cerebral aneurysms.

F Proust1, P Toussaint, J Garniéri

  • 1Department of Neurosurgery, Rouen University Hospital, France. Francois.Proust@chu-rouen.fr

Journal of Neurosurgery
|May 17, 2001
PubMed
Summary
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Pediatric aneurysms, unlike adult ones, have a distinct location distribution. While outcomes are similar to adults, initial subarachnoid hemorrhage and rebleeding are major causes of poor pediatric aneurysm outcomes.

Area of Science:

  • Neurosurgery
  • Pediatric Neurology
  • Vascular Neurology

Background:

  • Pediatric aneurysms present unique location and size characteristics compared to adult aneurysms.
  • Published literature offers limited insight into patient outcomes for pediatric aneurysms.
  • Subarachnoid hemorrhage (SAH) is a common presentation in pediatric aneurysm cases.

Purpose of the Study:

  • To analyze the characteristics, treatment, and outcomes of pediatric aneurysms.
  • To compare pediatric aneurysm features and outcomes with adult counterparts.
  • To identify factors contributing to poor outcomes in pediatric aneurysm patients.

Main Methods:

  • A retrospective study of 22 pediatric patients treated across three neurosurgery departments.
  • Preoperative status assessed using Hunt and Hess classification.

Related Experiment Videos

  • Postoperative evaluation using Glasgow Outcome Scale (GOS) 2-10 years after treatment.
  • Imaging included computerized tomography and angiography.

    • Main Results:

    • Symptomatic aneurysms showed specific locations: internal carotid artery bifurcation (36.4%), middle cerebral artery (36.4%), anterior communicating artery (18.2%), and vertebrobasilar system (9.1%).
    • Giant aneurysms occurred in 14% of patients.
    • Favorable outcomes (GOS Score 5) were achieved in 63.6% of patients; mortality was 22.7%.

    Conclusions:

    • Pediatric aneurysms exhibit a unique anatomical distribution compared to adult aneurysms.
    • The incidence of giant aneurysms and overall outcomes in children resemble those in adults.
    • Initial SAH, particularly rebleeding due to delayed diagnosis, significantly impacts poor outcomes in pediatric aneurysm patients.