gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

Intracranial aneurysms in pediatric patients – characteristics of unruptured and ruptured aneurysms after clipping and coiling

Meeting Abstract

  • S. Eibach - Klinik für Neurochirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt am Main
  • E. Güresir - Klinik für Neurochirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt am Main
  • V. Seifert - Klinik für Neurochirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt am Main
  • H. Vatter - Klinik für Neurochirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt am Main

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocP 043

DOI: 10.3205/11dgnc264, URN: urn:nbn:de:0183-11dgnc2640

Published: April 28, 2011

© 2011 Eibach et al.
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Outline

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Objective: With a low incidence of intracranial aneurysms in pediatric patients, both ruptured and unruptured aneurysms have different characteristics mainly in respect to distribution, course of disease and outcome.

Methods: Between 1999 and 2009, 9 pediatric patients (age ≤ 18 years) with intracranial aneurysms were treated at our institution and were entered into a prospectively conducted database. We analyzed this special subgroup regarding age, ruptured versus unruptured aneurysms and localization of aneurysms. Clinical admission status after subarachnoid hemorrhage (SAH) was assessed by WFNS grade. Outcome was assessed according to the modified Rankin scale (mRs) after 6 months.

Results: The pediatric patients had a mean age of 13.2 years. 4 of the 9 patients had an unruptured aneurysm, whereas 5 had suffered from SAH. 3.6 was the mean WFNS admission grade after SAH. The internal carotid artery (ICA) was the most common aneurysm site (4 of 9). Other aneurysms were located at the basilar artery (1), at the posterior cerebral artery (1), at the pericallosal artery (1) and at the middle cerebral artery (2). Outcome was favorable in all patients with unruptured aneurysms. In the SAH group, mean outcome according to mRs was 3. In the group of 9 pediatric patients one had a giant aneurysm of the internal carotid artery. 2 patients suffered from a re-rupture after complete surgical treatment of the aneuryms due to progressive reformation of the aneurysm, one of them even suffered from re-bleeding twice. One patient had a traumatic pseudo-aneurysm.

Conclusions: Subarachnoid hemorrhage is a rare disease in childhood. ICA bifurcation is the most common aneurysm location in the pediatric population. In our series, outcome after 6 months is better than in the adult population. There is a higher incidence of atypical or complex aneurysms.