Pediatric Intracranial Aneurysms

Abstract

Pediatric intracranial aneurysms are rare, representing less than 5% of all cases in most hospital series. Nevertheless, a ruptured aneurysm is an important differential diagnosis in children with hemorrhagic stroke, particularly among those with subarachnoid hemorrhage. Children may also present with cranial nerve dysfunction, focal neurologic deficits, brainstem compression, or seizures due to an unruptured aneurysm’s mass effect. While the majority of pediatric intracranial aneurysms are idiopathic, a significant number are infectious or traumatic in origin. As many as one-third of patients have an underlying syndrome or associated disease condition, affecting the integrity of vessel walls. In this article, the authors review the epidemiology, pathogenesis, classification, natural history, diagnostic workup, and microsurgical and endovascular treatment of pediatric intracranial aneurysms, highlighting important differences between children and adults. A comprehensive summary of relevant studies published from 2001 onwards is also presented.