title: Clinical and radiological profiles and outcomes in pediatric patients with intracranial aneurysms.
abstract: OBJECTIVE
  Intracranial aneurysms are extremely uncommon in the pediatric population, their characteristics are not well studied, and certain features make them unique. The authors analyzed pediatric patients with aneurysms to try to understand their clinical, radiological, and outcome profile.
  
  
  METHODS
  Sixty-three pediatric patients (≤ 18 years of age) with ages ranging from 4 to 18 years and features (clinical and radiological) suggestive of aneurysm presented to, and were treated at, the authors' center in the past 20 years (1991-2011). Included in the present study were only those patients who underwent surgical intervention, and thus data for 57 patients were analyzed.
  
  
  RESULTS
  Seventy-three aneurysms in 57 patients were surgically treated. There was a slight female predominance (M/F 1:1.2), and the mean age among all patients was 12.69 ± 3.75 years. Fifty patients (87.72%) presented with subarachnoid hemorrhage, 4 (7.02%) with mass effect, and 3 (5.26%) with seizure. On presentation the majority of patients (45 [78.95%]) had a good clinical grade. Eleven patients had multiple aneurysms. The internal carotid artery (ICA) bifurcation was the most common aneurysm site (18 cases [24.66%]), followed by the middle cerebral artery (MCA) bifurcation (11 cases [15.07%]). At a mean follow-up of 18.58 ± 10.71 months (range 1.5-44 months), 44 patients (77.19%) had a favorable outcome, and 5 patients had died.
  
  
  CONCLUSIONS
  Pediatric patients with intracranial aneurysms most commonly presented with subarachnoid hemorrhage, and there was a slight female predominance. The ICA bifurcation followed by the MCA bifurcation was the most common aneurysm site. The incidence of posterior circulation and giant aneurysms is higher in pediatric patients than in the adult population. Children tend to present with better clinical grades and have better overall survival results and good functional outcomes.
authors.affiliation: Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India. dranantmehrotra@gmail.com
authors.forename: Anant
authors.initials: A
authors.lastname: Mehrotra
authors.forename: Anup P
authors.initials: AP
authors.lastname: Nair
authors.forename: Kuntal Kanti
authors.initials: KK
authors.lastname: Das
authors.forename: Arun
authors.initials: A
authors.lastname: Srivastava
authors.forename: Rabi Narayan
authors.initials: RN
authors.lastname: Sahu
authors.forename: Raj
authors.initials: R
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D002343:Carotid Artery, Internal / Q000473:pathology; D002560:Cerebrovascular Circulation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D002532:Intracranial Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008866:Microsurgery; D020768:Middle Cerebral Artery / Q000473:pathology; D019635:Neurosurgical Procedures / Q000379:methods; D011859:Radiography; D012720:Severity of Illness Index; D017678:Sex Distribution; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods; D020301:Vasospasm, Intracranial / Q000209:etiology