title: Giant intracranial aneurysms in the paediatric population: Suggested management and a review of the literature.
abstract: OBJECTIVE
  Intracranial aneurysms are rare in children although giant aneurysms more commonly occur in adolescence. The aims of our study were to perform an extensive review of the literature over the past two decades and assess intracranial aneurysm management.
  
  
  METHODS
  Based on a Pubmed search, we carried out a review of the literature from 1990 to 2012 regarding giant intracranial aneurysms diagnosed in the paediatric population. This descriptive study concerned clinical presentation, cerebral aneurysm characteristics, therapeutic management procedures and outcome.
  
  
  RESULTS
  Forty-six cases were reported in 31 papers. The male/female sex ratio was 1.15, the clinical presentation was a tumour mass syndrome in 56.6%, followed by rupture in 30.4%. The aneurysm location was the posterior circulation in 41.3%, and microsurgical treatment (52.2%) predominated over endovascular coiling (28.3%).
  
  
  CONCLUSIONS
  To date, no evidence-based medicine recommendation has been accepted for the management of rare intracranial aneurysms. Each reported patient was the object of a multidisciplinary clinical decision. Management of this challenging pathology should be performed on a case-to-case basis.
authors.affiliation: Department of Neurosurgery, Rouen University Hospital, 76031 Rouen, France.
authors.forename: A-S
authors.initials: AS
authors.lastname: Pruvot
authors.affiliation: Department of Neurosurgery, Rouen University Hospital, 76031 Rouen, France.
authors.forename: S
authors.initials: S
authors.lastname: Curey
authors.affiliation: Department of Neurosurgery, Rouen University Hospital, 76031 Rouen, France.
authors.forename: S
authors.initials: S
authors.lastname: Derrey
authors.affiliation: Inserm U982, Neuronal and Neuroendocrine Communication and Differentiation, Rouen University, 76000 Rouen, France.
authors.forename: H
authors.initials: H
authors.lastname: Castel
authors.affiliation: Department of Neurosurgery, Rouen University Hospital, 76031 Rouen, France; Inserm U982, Neuronal and Neuroendocrine Communication and Differentiation, Rouen University, 76000 Rouen, France. Electronic address: Francois.Proust@chu-rouen.fr.
authors.forename: F
authors.initials: F
authors.lastname: Proust
mesh_terms: D002533:Cerebral Angiography / Q000379:methods; D002548:Cerebral Revascularization / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000628:therapy*; D019635:Neurosurgical Procedures / Q000379:methods; D016896:Treatment Outcome
keywords: Anévrisme cérébral géant; Children; Endovascular coiling; Exclusion microchirurgicale; Giant cerebral aneurysm; Microsurgical clipping; Occlusion endovasculaire; Pédiatrie; Review of the literature; Revue de la littérature