Incidence, Management, and Outcomes of Pediatric Infectious Aneurysms

Infectious intracranial aneurysms (IIAs) are rare cerebrovascular complications of infective endocarditis (IE) accounting approximatively for 0.5% to 6.5% of all aneurysms. In children, mycotic aneurysms secondary to IE are uncommon.

This is a retrospective study of patients treated for pediatric IIA secondary to IE at our institution with an emphasis on presentation, etiologies, nuances in management, and outcomes.

One hundred fifty-one patients were treated for IE secondary to congenital or acquired heart disease, of which 13 patients (8.6%) presented with intracranial hemorrhage. IIA occurred in 5 patients (2.6%) with IE. IIA accounted for 15% of intracranial aneurysms treated during the study period.

Pediatric patients with ruptured IIAs have a high rate of rerupture, and early surgical intervention should be considered through an open or endovascular route when available.