Paediatric Intracranial Aneurysms

Summary

Aims and background:
The aim of this paper is to discuss the anatomical and clinical features of paediatric aneurysms and present our experience in their treatment, including that of long-term outcome.

Methods:
Eleven paediatric patients with a total of 13 intracranial aneurysms were included in the study. The clinical data were retrospectively analysed from patient charts and imaging studies. The treatment strategy selected was evaluated. The resultant outcome was graded according to Rankin score during a follow-up ranging from 0 to 144 months.

Results:
In seven patients the aneurysms were considered inoperable or the risk associated with surgery was too high, and therefore endovascular treatment was preferred. Three patients were treated primarily surgically. One patient in deep coma following SAH was treated conservatively and died 24 hours after the bleed. Clinical improvement followed treatment in five patients who presented with a focal neurological deficit and an absence of SAH, so they were all ranked as Rankin 1. Four patients presenting with SAH were graded HH 1 to 3. In only one case did the focal neurological deficit improve, enabling the patient to be ranked as Rankin 1. Neurological deficit persisted in the remaining three patients, particularly in psychological terms, leading to grades of Rankin 2 to 3.

Conclusion:
The decision to perform endovascular or surgical treatment is based on location, aneurysm size, presence of intracerebral haematoma and overall patient condition. A multidisciplinary approach is recommended.

Key words:
paediatric aneurysm – neurosurgical and endovascular treatment – outcome

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