Intracranial Aneurysms in Children Homepage

Author

Thomas Beez, MD
Zsombor Gal, BA

Section Editors

Edward Smith, MD
Gianpiero Tamburrini, MD
Alfred Pokmeng See, MD

Editor in Chief

Rick Abbott, MD

Introduction

Intracranial aneurysms, which are localized dilations of blood vessels supplying the brain, are rare in children and account for less than 5% of cases treated in neurovascular centers (1,2). While the prevalence of intracranial aneurysms in adults without specific risk factors is estimated to be 2%, even large MRI or autopsy studies in children have detected no incidental aneurysms, reflecting the extreme rarity of intracranial aneurysm in children (3–6). Pediatric aneurysms differ from their adult counterparts in terms of location, type, presentation, and outcome. Treatment approaches may be surgical or endovascular, and outcomes of these approaches are generally favorable in children. Neither guidelines nor a robust evidence base for the treatment of pediatric intracranial aneurysms exists, establishing the need for prospective studies and registries.

Key Points

• Aneurysms rare in children: Pediatric aneurysms are rare and account for 0.5% to 4.6% of cases in large aneurysm series (1,2,7,8).
• Distinct features compared with adults: There is a higher incidence of posterior circulation aneurysms in children, as well as a higher incidence of giant, dissecting, and fusiform aneurysms (9).
• Consider multidisciplinary treatment: Surgical and endovascular obliteration procedures—including clipping, wrapping, coiling, stents, flow diverters, and bypass surgery—are all options for treatment (9–11).
• Better outcome: Compared to adults, children have a lower incidence of delayed cerebral ischemia after subarachnoid hemorrhage and experience better outcomes across treatment modalities (12,13).