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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
Iatrogenic intracranial aneurysms in childhood: case-based update
Emrah Egemen1, Luca Massimi, Concezio Di Rocco
1Neurosurgery Department, Gazi University Medical School, Beşevler, 06500 Ankara, Turkey. emrahegemen@yahoo.com
Summary
Iatrogenic aneurysms in children are rare, often asymptomatic, and typically involve the internal carotid artery. Conservative management may be suitable for non-progressive cases, but intervention is reserved for symptomatic or progressing lesions.
Area of Science:
- Pediatric Neurosurgery
- Vascular Neurology
- Interventional Radiology
Background:
- Iatrogenic aneurysms in children are exceptionally rare.
- Clinical presentations vary, with asymptomatic cases possible, particularly fusiform internal carotid artery dilatations.
- While radiological diagnosis is straightforward, management strategies for pediatric iatrogenic intracranial aneurysms remain debated.
Purpose of the Study:
- To report on the occurrence and management of iatrogenic fusiform internal carotid artery dilatations in pediatric patients.
- To discuss the clinical course and therapeutic options for these rare vascular lesions.
Main Methods:
- Three pediatric patients diagnosed with fusiform internal carotid artery dilatations during follow-up imaging post-suprasellar-parasellar tumor surgery.
- All patients were asymptomatic at diagnosis.
- Conservative management was initiated due to lack of lesion progression on serial imaging.
Main Results:
- All three pediatric patients with iatrogenic fusiform internal carotid artery dilatations remained asymptomatic.
- No progression of the aneurysmal dilatation was observed in any patient under conservative management.
- Patients demonstrated stability with the chosen conservative treatment approach.
Conclusions:
- Iatrogenic aneurysms in children can present atypically, and their optimal therapy is not definitively established.
- Fusiform internal carotid artery dilatations in pediatric patients rarely manifest symptoms, with no reported cases of subarachnoid hemorrhage.
- Treatment is challenging due to the origin of major arterial branches from the dilated segment; conservative management is viable for stable or healing aneurysms, while intervention is indicated for progression or symptomatic presentation.
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