Multimodal Treatment of Intracranial Aneurysms in Children: Clinical Case Series and Review of the Literature

Michael G.Z. Ghali, Visish M. Srinivasan, Jacob Cherian, Kathryn M. Wagner, Stephen R. Chen, Jeremiah Johnson, Sandi K. Lam, Peter Kan

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background: The management of intracranial aneurysms in the pediatric population presents unique challenges. Cases are rare and tend to be of higher complexity compared with aneurysms in adults. Outcomes in long-term follow-up are not well-characterized. Here we present illustrative case examples to demonstrate key concepts in managing these lesions in the context of the modern neurovascular era. Methods: Four institutional databases of neurovascular procedures from 2012 to 2017 were reviewed. Patients <18 years old who underwent treatment for intracranial aneurysms were included. Patient characteristics, aneurysm details, treatment information, and angiographic and clinical outcomes were recorded. Results: Ten cases of intracranial aneurysms in 9 children were identified. Management included direct clipping, trapping and bypass, endovascular coil embolization, endovascular vessel sacrifice, and flow diversion. Conclusions: The management of intracranial aneurysms in pediatric patients requires special considerations, from the diagnostic phase to treatment methods and follow-up regimen. These are ideally considered by a multidisciplinary team, with expertise from pediatric neurosurgeons, cerebrovascular neurosurgeons, and neurointerventionalists.

Original languageEnglish (US)
JournalWorld Neurosurgery
DOIs
StateAccepted/In press - Jan 1 2018
Externally publishedYes

Keywords

  • Aneurysms
  • Bypass
  • Clipping
  • Endovascular
  • Flow diversion
  • Intracranial
  • Pediatric

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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