Complications of Therapies for Intracranial Aneurysms in Children

Treatment-related morbidity is encountered in 20–25% of cases, and the surgical mortality rate is significantly less than 5% in most series (7, 30).

Surgical

Intraoperative complications

• Re-rupture of the aneurysm: In a series of 53 surgical procedures, intraoperative re-rupture occurred in 2 children; both cases were managed successfully (30).

Postoperative complications

• Hematoma: In a series of 53 surgical procedures, a postoperative intracranial hematoma occurred in two children (30).
• Permanent neurological deficit: In the same series a permanent neurological deficit was observed in three children (30).
• Hydrocephalus: In the same series two children required the placement of a ventriculoperitoneal shunt (30).
• Infection: Although no data are published specifically on postoperative infections after pediatric aneurysm surgery, an infection rate after craniotomy of about 0.5% can be expected. The most common bacteria are Staphylococcus aureus and gram-negative rods (14).

Endovascular

• Thromboembolic distal vessel occlusion: In a series of 32 children with cerebral aneurysms, embolization with either micro-glue or thrombus occurred in three cases (39).
• Rebleeding: In the same series, one case of re-rupture during endovascular aneurysm repair is reported (39).