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Intracranial arterial aneurysms in early childhood
L Ferrante1, A Fortuna, P Celli
1Department of Neurological Sciences, Università degli Studi di Roma La Sapienza, Italy.
Insights
Pediatric cerebral saccular aneurysms are rare and distinct from adult cases. Congenital factors likely contribute to their development, with better surgical outcomes observed in children.
Area of Science:
- Neurology
- Pediatric Neurosurgery
- Vascular Neurology
Background:
- Cerebral saccular aneurysms are uncommon in children under five.
- Analysis includes 71 literature cases and one new case.
Observation:
- Pediatric aneurysms exhibit distinct features compared to adult counterparts.
- Higher incidence in the first two years of life suggests congenital origins.
- Frequent peripheral location (41.6%) and large/giant size (50%/26.8%) are noted.
Findings:
- Congenital pathogenesis is strongly supported by early-onset, location, and size.
- Association with other congenital vascular abnormalities is common.
- Nonhemorrhagic onset occurs in 18.1% of pediatric cases, versus 2.5% in adults.
Implications:
- Understanding unique pediatric aneurysm characteristics is crucial for diagnosis and treatment.
- Improved surgical outcomes in children suggest potential for better long-term prognoses.
- Further research into congenital factors may reveal novel therapeutic targets.
Abstract:
Cerebral saccular aneurysms are rare in early childhood. Seventy-one cases in children under 5 years of age found in the literature, plus one case of our own, are analyzed. In early childhood these aneurysms seem to have features that distinguish them from the same variety in adults. In children a congenital pathogenesis appears more convincing because of the higher frequency in the first 2 years of life, the often peripheral site (41.6%), the high frequency of large (50%) or giant (26.8%) aneurysms, and the association with other cerebral and vascular congenital abnormalities. Onset was nonhemorrhagic in 18.1% of cases compared with 2.5% in adults. The surgical outcome seems better in children than in adult patients in terms of both morbidity and mortality.