title: Patterns of treatment and associated short-term outcomes of unruptured intracranial aneurysms in children.
abstract: BACKGROUND
  The rates and outcomes of treatments for intracranial aneurysms have not been exclusively determined within the pediatric population. We determined the rates of endovascular and microsurgical treatments for unruptured intracranial aneurysms (UIA) and associated rates of favorable outcome in patients aged <18 years.
  
  
  METHODS
  We analyzed data obtained as part of the Kids' Inpatient Database between 2003 and 2009 with primary diagnosis of UIA. Patients undergoing endovascular treatment were compared to those undergoing microsurgical treatment. We determined rates of intracerebral hemorrhage, subarachnoid hemorrhage, neurological complications, and favorable outcome.
  
  
  RESULTS
  There were 818 cases of UIA during the study period. A total of 111 patients (mean age 14 ± 6 years, 37.6 % female) underwent microsurgical treatment, and another 200 patients (mean age 13 ± 7 years, 42.5 % female) underwent endovascular treatment. A high rate of favorable outcome was observed in patients who received either treatment (microsurgical treatment 87.7 % versus endovascular treatment 91.6 %, p = 0.4). There was a trend towards a significantly shorter mean hospitalization stay among those who received endovascular treatment compared with microsurgical treatment (6 ± 12 versus 9 ± 11 days, p = 0.06). There was a significant trend towards higher utilization of endovascular treatment as opposed to microsurgical treatment from 2003 to 2009 (p = 0.02).
  
  
  CONCLUSIONS
  Although outcomes except for length of stay were comparable between endovascular treatment and microsurgical treatment patients, there was a trend towards higher utilization of endovascular treatment among children with UIAs from 2003 to 2009.
authors.affiliation: Department of Neurology, University of Florida College of Medicine, HSC Box 100236, Gainesville, FL, 32610, USA, ganesh785@gmail.com.
authors.forename: Ganesh
authors.initials: G
authors.lastname: Asaithambi
authors.forename: Malik M
authors.initials: MM
authors.lastname: Adil
authors.forename: Kavisha M
authors.initials: KM
authors.lastname: Shah
authors.forename: Lori C
authors.initials: LC
authors.lastname: Jordan
authors.forename: Adnan I
authors.initials: AI
authors.lastname: Qureshi
mesh_terms: D000293:Adolescent; D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000209:etiology; D002648:Child; D016208:Databases, Factual / Q000706:statistics & numerical data; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000009:adverse effects* / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult
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