[Aneurysms of cerebral arteries in children and adolescents].

BACKGROUND

Intracranial aneurysms are rare lesions in children and adolescents and their epidemiology, clinical and anatomic features are poorly understood. Aim of the study was to reveal the specific features of cerebral aneurysms in children and adolescents and to develop guidelines for management of these patients.

MATERIALS AND

METHODS

The study was performed on consecutive series of 125 patients under 18 years of age harboring 145 aneurysms. All of them were treated in Burdenko Neurosurgical Institute (Moscow, Russia) from 1987 to 2007.

RESULTS

Specific features of pediatric aneurysms include: high incidence on a background of connective tissue disorder (42%) and abnormalities of circle of Willis (20%), frequent localization in bifurcation of internal carotid artery (13.8%), its cavernous segment (17.9%), or in posterior part of circle of Willis (23.5%). In children giant aneurysms were observed in 31.7% of cases, fusiform in 19.3% and partially thrombosed in 33.8%. Complications of aneurysms in children with hemorrhagic type of course included recurrent hemorrhages (42.9%), hematomas (31%), hydrocephalus (16.7%) and seizures (33.3%). Generally, 107 pediatric patients (85.6%) with 118 aneurysm (81.4%) were operated. Microsurgical treatment was performed in 57% of patients and endovascular procedures in 43% In the series of 107 operated patients we observed excellent early postoperative results in 53 cases (49.5%), good in 45 (42.1%) and poor in 9 (8.4%). Postoperative mortality was 0.95% (1 patient).

CONCLUSION

Considerable proportion of complex aneurysms in children and adolescents produces certain difficulties of treatment; however, due to good functional outcomes in this age group the range of causes of denial must be minimized.