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Acta Neurochirurgica

Erschienen in:

02.06.2018 | Original Article - Pediatric Neurosurgery

Pediatric intracranial distal arterial aneurysms: report of 35 cases

verfasst von: Ruiqi Chen, Si Zhang, Rui Guo, Lu Ma, Chao You

Erschienen in: Acta Neurochirurgica | Ausgabe 8/2018

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Abstract

Background

Although research on pediatric intracranial aneurysms is well documented, studies of pediatric intracranial distal arterial aneurysms (PIDAAs) remain scarce.

Methods

All pediatric patients (≤ 18 years) with intracranial aneurysms located distally to the M2 segment of the middle cerebral artery (MCA), A2 segment of the anterior cerebral artery, P2 segment of the posterior cerebral artery, and other cerebral arteries distal to the main branch who were treated at our center between January 2012 and April 2017 were retrospectively reviewed.

Results

Thirty-five PIDAAs were observed in 35 patients with a mean age of 9.2 ± 5.9 years and a male ratio of 71.4% (n = 25). Sudden onset of severe headache was the most common symptom (n = 22, 62.9%), followed by seizures (n = 21, 60%). Twenty-seven patients (77.1%) had ruptured aneurysms, and 18 of them (66.7%) exhibited combined lobe intracerebral hematoma. MCA was the most common site (n = 23, 65.7%). Large or giant aneurysms were observed in 16 patients (45.7%). Eight patients (22.9%) had pseudoaneurysms, six of whom (75%) reported a head trauma history. Thirty patients (85.7%) had favorable outcomes at the end of the 6-month follow-up. Kaplan-Meier 6-month seizure curves revealed a significantly higher decrease in seizure rates in the surgical group than in the endovascular group (P = 0.036).

Conclusions

PIDAAs constitute a high proportion of pediatric intracranial aneurysms. PIDAAs are associated with an increased risk of seizures, a predilection for the MCA, and a high incidence of pseudoaneurysms with head trauma history. Surgical intervention is of greater benefit than endovascular treatment in controlling the risk of seizures.

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Titel: Pediatric intracranial distal arterial aneurysms: report of 35 cases
verfasst von: Ruiqi Chen
Si Zhang
Rui Guo
Lu Ma
Chao You
Publikationsdatum: 02.06.2018
Verlag: Springer Vienna
Erschienen in: Acta Neurochirurgica / Ausgabe 8/2018
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-018-3574-0

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Pediatric intracranial distal arterial aneurysms: report of 35 cases

Abstract

Background

Methods

Results

Conclusions

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