Aneurysms in children: review of 15 years experience.
BACKGROUND
Intracranial aneurysms in children are rare. The location, size, age, and presentation in the young are markedly different from that of adults. The 15-year experience of the senior author in southern California is presented.


METHODS
All paediatric patients treated for cerebral aneurysm over a 15-year period were identified. Intraoperative and postoperative data were collected retrospectively from the medical records. The need for additional surgery as well as the incidence of complications including death, hemiparesis, seizures, memory disturbances, and the need for subsequent cerebrospinal fluid (CSF) diversion were identified.


RESULTS
Fifty children were identified (54 lesions). Subarachnoid haemorrhage was the most common mode of presentation with the average Hunt-Hess grade being I-II. The locations of the lesions were middle cerebral (10), internal carotid (8), anterior communicating (7), posterior cerebral (6), posterior communicating (5), pericallosal (4), anterior cerebral (3), choroidal (3), posterior inferior cerebellar (3), basilar (2), vertebral (2) and frontopolar (1) arteries. Clinical vasospasm was encountered in eight of our patients, but no cases were observed in those younger than nine years. Long-term outcome was excellent in 22 cases, good in 20 and poor in nine, with one death and two patients lost to follow-up.


CONCLUSIONS
Analysis of our data suggested a predilection for the posterior circulation compared to adults, larger size, more complex architecture, and a decreased incidence of clinical vasospasm in the younger age group. This series and a review of the literature suggest that aneurysmal disease in children may be distinct from that of adults.
Aryan
Henry E
HE
Division of Neurosurgery, University of California San Diego Medical Center, 200 W. Arbor Drive, Suite 8893, San Diego, California 92103-8893, USA. hearyan@ucsd.edu
Giannotta
Steven L
SL
Fukushima
Takanori
T
Park
Min S
MS
Ozgur
Burak M
BM
Levy
Michael L
ML
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D002532:Intracranial Aneurysm / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D007431:Intraoperative Complications / Q000453:epidemiology; D008297:Male; D019635:Neurosurgical Procedures; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome