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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
Intracranial aneurysms in adolescents
Jian-tao Liang1, Li-rong Huo, Yu-hai Bao
1Department of Neurosurgery, Peking University Third Hospital, Haidian District, Beijing, 100191, China.
Summary
Intracranial aneurysms are rare in adolescents but present differently than in adults. Both surgical and endovascular treatments are effective, with favorable outcomes for treated patients.
Area of Science:
- Neurology
- Neurosurgery
- Pediatric Neurology
Background:
- Intracranial aneurysms are uncommon in the adolescent population.
- Adolescent intracranial aneurysms exhibit distinct clinical and radiological features compared to adult cases.
Purpose of the Study:
- To assess the clinical and radiological characteristics of intracranial aneurysms in adolescents aged 15-18 years.
- To clarify the optimal therapeutic strategies for intracranial aneurysms in this age group.
Main Methods:
- Retrospective review of 16 adolescents with 20 intracranial aneurysms from a dedicated databank (1985-2008).
- Analysis of clinical presentation, aneurysm location, and treatment modalities (endovascular vs. microsurgical).
Main Results:
- Adolescent aneurysms represented 0.91% of all intracranial aneurysms, with a male predominance.
- Aneurysms were predominantly in the anterior circulation (75%), with 25% on the middle cerebral artery (MCA).
- Half presented with subarachnoid hemorrhage; others had mass effect symptoms. Both endovascular and microsurgical treatments yielded favorable outcomes.
Conclusions:
- Adolescent intracranial aneurysms show male predominance, higher incidence of large/giant, traumatic, dissecting, and fusiform types, and posterior circulation involvement.
- Spontaneous thrombosis and better Hunt-Huntess grades at presentation are noted in adolescents.
- Both microsurgery and endovascular treatments are effective; parent artery occlusion or EC-IC bypass may be best for complex cases.
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