Flow Diversion for Treatment of Growing A2 Aneurysm in a Child: Case Report and Review of Flow Diversion for Intracranial Aneurysms in Pediatric Patients.
BACKGROUND
Intracranial flow diversion has gained increasing popularity since the approval of the Pipeline Embolization Device (PED). Although it is only approved for use in adult patients, the PED has been used to treat aneurysms in pediatric patients. We present the first reported case of the use of a PED in a pediatric patient to treat an unusual fusiform distal anterior cerebral artery aneurysm.


METHODS
A 12-year-old girl presented with new onset seizures and was found to have a distal left anterior cerebral artery aneurysm. Initially, this was managed conservatively, but follow-up imaging performed 4 months after presentation demonstrated enlargement of the aneurysm. The patient underwent endovascular embolization of her aneurysm with PED. This was successfully performed and the patient recovered from the procedure with no neurologic deficits.


CONCLUSIONS
Follow-up digital subtraction angiography and magnetic resonance angiography at 6 and 12 months, respectively, showed complete occlusion of the aneurysm. We also reviewed the literature on flow diversion for treatment of pediatric intracranial aneurysms.
Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA; Department of Neurosurgery, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA.
Jay Ashok
JA
Vachhani
Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA; Department of Neurosurgery, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA.
Christopher Michael
CM
Nickele
Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA; Department of Neurosurgery, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA; Department of Neurology, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA.
Lucas
L
Elijovich
Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA; Department of Neurosurgery, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA.
Paul
P
Klimo
Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA; Department of Neurosurgery, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA. Electronic address: aarthur@semmes-murphey.com.
Adam Stephen
AS
Arthur
D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D002648:Child; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000601:surgery*; D018810:Magnetic Resonance Angiography; D011183:Postoperative Complications / Q000175:diagnosis; D015607:Stents
Aneurysm; Flow diversion; Intracranial; Pediatric