title: Pediatric intracranial aneurysms: an institutional experience.
abstract: BACKGROUND
  Intracranial aneurysms are extremely uncommon in the pediatric population. Their epidemiology is poorly understood, and certain features make them unique. In our study we analyzed pediatric intracranial aneurysm patients to gain an insight into the epidemiology, clinicoradiological profile and outcome.
  
  
  METHODS
  Out of 36 children (< or =18 years of age; male:female ratio = 1.076:1; mean age 13.19 +/- 3.72 years, age range 5-18 years) presenting with subarachnoid hemorrhage (SAH; n = 33; 91.67%) and mass effect (n = 3; 8.33%), 27 who were positive on digital subtraction angiography and treated for intracranial aneurysms between January 1991 and February 2007 were included in this study.
  
  
  RESULTS
  At presentation, the majority (n = 21) of the pediatric intracranial patients showed a good grade, and 23 (85.18%) presented with SAH. Sudden severe headache (n = 19; 70.37%) and loss of consciousness (n = 14; 51.85%) were the most common symptoms, and meningeal signs (n = 18; 66.66%) most commonly elicitable. There were 7 patients with giant aneurysms and 8 patients with posterior circulation aneurysms. Internal carotid artery (ICA) bifurcations (n = 6; 18.18%) followed by middle cerebral artery (MCA) bifurcations (n = 4; 12.12%) were the most common sites. At a mean follow-up of 18.67 +/- 10.85 months (range 1-42 months), there were 21 (77.77%) patients with favorable outcome and 3 patients died.
  
  
  CONCLUSIONS
  Intracranial aneurysms in children commonly present with SAH; there is a male predominance, and ICA bifurcations followed by MCA bifurcations are the most common sites. The incidence of posterior circulation aneurysms and giant aneurysms is higher as compared to adults. The pediatric patients present with better grades and have better overall surgical results.
authors.affiliation: Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Vivek Kumar
authors.initials: VK
authors.lastname: Vaid
authors.forename: Raj
authors.initials: R
authors.lastname: Kumar
authors.forename: Samir Kumar
authors.initials: SK
authors.lastname: Kalra
authors.forename: Ashok Kumar
authors.initials: AK
authors.lastname: Mahapatra
authors.forename: Vijendra Kumar
authors.initials: VK
authors.lastname: Jain
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D008297:Male