Tap on and choose 'Add to Home Screen' to create a shortcut app

Tap on and choose 'Add to Home Screen/Install App' to create a shortcut app

Pathology of Intracranial Aneurysms in Children

This page was last updated on May 9th, 2017



  • Unclear pathophysiology: Contemporary insight into the pathophysiology of intracranial aneurysms in general contradicts the classical concept of aneurysms being truly congenital lesions. Laboratory research (with specimens from adults) revealed an average age of collagen within aneurysms of less than 5 years, indicating a high turnover (19).
  • Abnormality in repair processes: An alternative hypothesis is the concept of an underlying vessel wall dysfunction with transient or permanent failure to repair insults. Abluminal and luminal factors are thought to play a role (37).

Etiology and classification

Pediatric aneurysms are most commonly classified into the following categories, although certain overlaps exist, with regard to their etiology and configuration (2, 38):

  • Saccular (“berry”) aneurysms
  • Nontraumatic dissecting aneurysms
  • Giant aneurysms
  • Traumatic aneurysms
  • Infectious(“mycotic”) aneurysms
  • Iatrogenic aneurysms: Another rare form of aneurysms occurs after surgical intervention, such as brain tumor resection (15), or radiotherapy (9).


In a literature review of 480 pediatric aneurysms, the author found the vascular distribution below.

Vascular Distribution of 480 Pediatric Aneurysms: ACA=ant. cerebral art., ACoA=ant. communicating art., AICA=ant. inf. cerebellar art., BA=basilar art., ICA=int. carotid art., MCA=middle cerebral art., PCA = post. cerebral art., PCoA=post. communicating art., SCA=sup. cerebellar art., VA=vertebral art.


Molecular/Genetic Pathology

  • Predisposition: Genetic conditions predisposing for intracranial aneurysms in children are mainly sickle-cell anemia, phakomatoses (e.g., tuberous sclerosis complex, NF1) and heritable connective tissue disorders (e.g., Ehlers-Danlos and Marfan syndromes) (3, 21, 28, 52, 63).
  • Manifestation: Important implications of underlying genetic pathology are higher rates of multiple aneurysms (60% of cases) and presentation at younger age (<40 years of age), most evident for sickle-cell anemia (52, 54).


  • Abnormality of internal elastic membrane: Absence or irregular disruption of the internal elastic membrane is the most common histopathological observation (22).

Your donations keep us going

The ISPN Guide is free to use, but we rely on donations to fund our ongoing work and to maintain more than a thousand pages of information created to disseminate the most up-to-date knowledge in the field of paediatric neurosurgery.

By making a donation to The ISPN Guide you are also indirectly helping the many thousands of children around the world whose treatment depends on well-informed surgeons.

Please consider making a donation today.

Use the app

The ISPN Guide can be used as a standalone app, both on mobile devices and desktop computers. It’s quick and easy to use.

Fully featured

Free registration grants you full access to The Guide and host of featured designed to help further your own education.

Stay updated

The ISPN Guide continues to expand both in breadth and depth. Join our mailing list to stay up-to-date with our progress.