Endovascular management of paediatric intracranial aneurysms

The purpose of this paper is to discuss the radiological and clinical features of paediatric intracranial aneurysms including endovascular techniques currently being used for their therapy. Paediatric patients who presented with the diagnosis of intracranial aneurysm between August 1982 and February 1997 were included. The data were collected retrospectively. Clinical features included patient's age, sex, presentation, treatment and outcome. Radiologic features included location, size and number of aneurysms present. 21 patients (13 females and 8 males) ranging in age from 9 months to 16 years had intracranial aneurysms. Seventy six percent of the aneurysms were located in the anterior circulation and 24% in the posterior circulation. Seven patients (33%) had giant aneurysms and three patients (14%) had multiple aneurysms. Endovascular treatment was performed in six patients (29%) and neurosurgical treatment in eight patients (38%). Endovascular treatment included the use of coils and/or balloon occlusion. Of the remaining patients, two (9.5%) died prior to any surgical or radiological intervention. A further five patients (24%) were treated conservatively. Intracranial aneurysms in children demonstrate clinical and radiologic features that differ significantly from those seen in adults. There is a higher percentage of ICA termination aneurysms, giant aneurysms and posttraumatic aneurysms. However, aneurysms in children, like those in adults, can and have been successfully treated utilizing endovascular as well as neurosurgical techniques.