Garg Kanwaljeet, Singh Pankaj Kumar, Sharma Bhawani Shankar, Chandra Poodipedi Sarat, Suri Ashish, Singh Manmohanjit, Kumar Rajinder, Kale Shashank Sarad, Mishra Nalin Kumar, Gaikwad Shailesh K, Mahapatra Ashok Kumar
Department of Neurosurgery, Cardio-Neuro Centre, All India Institute of Medical Sciences, Room No 720, New Delhi, India.
Childs Nerv Syst. 2014 May;30(5):873-83. doi: 10.1007/s00381-013-2336-9. Epub 2013 Dec 10.
Intracranial aneurysms in children are not as common as in adults and there are many differences in the etiology, demographic variables, aneurysm location, aneurysm morphological characteristics, clinical presentation, and outcome in pediatric and adult intracranial aneurysms.
All children (≤18 years) suffering from intracranial aneurysm managed at our center from July 2001 through June 2013 were included in the study, and the details of these patients were retrieved from the computerized database of our hospital.
A total of 62 pediatric patients were treated for 74 aneurysms during the study period and constituted 2.3% of all intracranial aneurysms treated during the same period. The mean age at presentation was 13.5 years. Headache (82%) was the commonest presenting feature; other symptoms included seizures (21%), ictal loss of consciousness (27%), and motor/cranial nerve deficits (22.6%). Computed tomogram revealed subarachnoid hemorrhage in 58% of patients. Eighty-two percent of aneurysms were in anterior circulation. Sixty-seven percent of aneurysms were complex aneurysms. Fifty-eight percent of patients underwent surgical intervention while 30% underwent endovascular procedures. Twenty-one percent of the patients developed vasospasm. There was no postoperative mortality. Favorable outcome was seen in 72% of the patients.
Pediatric intracranial aneurysms are uncommon as compared to in adult patients. Seizures and cranial nerve involvement are seen more often as the presenting features in children. Posterior circulation aneurysms are more common in children, as are the internal carotid artery bifurcation aneurysms. There is high incidence of giant, posttraumatic, and mycotic aneurysms in children.
儿童颅内动脉瘤不如成人常见，儿童和成人颅内动脉瘤在病因、人口统计学变量、动脉瘤位置、动脉瘤形态特征、临床表现及预后等方面存在诸多差异。
纳入2001年7月至2013年6月在本中心接受治疗的所有≤18岁颅内动脉瘤患儿，这些患者的详细信息从我院计算机数据库中检索获得。
研究期间共62例儿童患者接受了74个动脉瘤的治疗，占同期所有颅内动脉瘤治疗病例的2.3%。就诊时的平均年龄为13.5岁。头痛（82%）是最常见的症状；其他症状包括癫痫发作（21%）、发作时意识丧失（27%）以及运动/脑神经功能缺损（22.6%）。计算机断层扫描显示58%的患者有蛛网膜下腔出血。82%的动脉瘤位于前循环。67%的动脉瘤为复杂动脉瘤。58%的患者接受了手术干预，30%的患者接受了血管内治疗。21%的患者发生了血管痉挛。无术后死亡病例。72%的患者预后良好。
与成人患者相比，儿童颅内动脉瘤并不常见。癫痫发作和脑神经受累在儿童中更常作为首发症状出现。后循环动脉瘤在儿童中更常见，颈内动脉分叉处动脉瘤也是如此。儿童中巨大、创伤后和霉菌性动脉瘤的发生率较高。
