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 Vol. 16 No. 1, July 2006
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AAP Grand Rounds 16:84-85 (2006)
© 2006 American Academy of Pediatrics

NEUROLOGICAL SURGERY

Modern Management of Pediatric Intracerebral Aneurysms

Source: Sanai N, Quinones-Hinojosa A, Gupta NM, et al. Pediatric intracranial aneurysms: durability of treatment following microsurgical and endovascular management. J Neurosurg (2 Suppl Pediatrics). 2006;104:82–89; doi:10.1016/S0140-6736(06)67968-3.

The first 20% of the full text of this article appears below.

A multidisciplinary group from the University of California at San Francisco reports a retrospective review of the treatment and outcome of intracranial aneurysms in 32 pediatric patients (range 2 months to 18 years) with a total of 43 aneurysms – one of the largest series ever presented from a single institution. Aneurysms in children are pathologically and morphologically different from those in adults, which are typically defects in the muscular layer of the vessel with a focal outpouching of adventitia that are thought to arise as a result of chronic hemodynamic stresses at branch points of intracerebral vessels. As a result the aneurysm in adults is small, "berry"-like in appearance and contains a thin wall that is prone to rupture. Consequently, the most common clinical presentation in adults is sub-arachnoid hemorrhage (SAH), which is clinically manifest as an acute, severe headache with an associated neurologic deficit that may range from negligible to severe.

In this series, SAH occurred in 7 patients (22%), 5 of whom presented with low-grade SAH (Grade I or II). Nine patients (28%) presented . . . [Full Text of this Article]

Jeffrey P. Blount, MD, FACS, FAAP
Pediatric Neurosurgery, Children’s Hospital of Alabama/UAB, Birmingham, AL