Turkish Neurosurgery 2021 , Vol 31 , Num 5
Characteristics and Surgical Outcomes of Pediatric Intracranial Aneurysms in Romania
Alexandru-Vlad CIUREA1,Aurel MOHAN2,Andrei VOICU3,Vicentiu SACELEANU4,Mihai-Stelian MOREANU1,Horia PLES5
1University of Medicine and Pharmacy Carol Davila, Department of Neurosurgery, Bucharest, Romania
2Bihor County Emergency Hospital, Department of Neurosurgery, Oradea, Romania
3Bucharest Emergency Teaching Hospital, Department of Neurosurgery, Bucharest, Romania
4Sibiu County Emergency Hospital, Department of Neurosurgery, Sibiu, Romania
5Timis County Emergency Hospital, Department of Neurosurgery, Timisoara, Romania
DOI : 10.5137/1019-5149.JTN.32954-20.2 AIM: To analyze the demographic characteristics and surgical outcomes of the largest series of patients with pediatric aneurysms reported in Romania, in consideration of the primary factors that lead to good long-term outcomes. Given that all cases involved ruptured aneurysms, we also investigated the ability of microsurgical clipping to prevent massive hemorrhage andaggravation of neurological deficits.

MATERIAL and METHODS: This multicenter retrospective study included 47 pediatric patients (<16 years old) who underwent operation over the 20-year period between January 1999 and January 2019. We analyzed medical records and imaging findings in each patient. Treatment consisted of open microsurgical dissection (clipping) and endovascular embolization (coiling).

RESULTS: Mean patient age was 14.3 years, ranging from 5 months to 16 years, with 28 boys (59.5%) and 19 girls (40.4%). In our series, pediatric aneurysms represented 6.1% of all intracranial aneurysms (771 cases). Clinical features were dominated by headache (45 cases, 95.7%), neck stiffness (43 cases, 91.4%) and vomiting (42 cases, 89.3%). The most frequently involved locations were the anterior communicating artery (17 cases, 36.1%), middle cerebral artery (12 cases, 25.5%), and internal carotid artery bifurcation (9 cases, 19.1%). Glasgow Outcome Scale scores at 6 months indicated good recovery in 36 patients (76.5%), moderate disability in ninepatients (19.1%), severe disability in one patient (2.1%), and (preoperative) death in one patient (2.1%).

CONCLUSION: Intracranial aneurysms in children are very rare. Early diagnosis based on brain imaging and microsurgical treatment is essential for attaining excellent results.Primary factors such as preoperative status, child profile, aneurysm size, treatment choice, and timing of the operation influence both short and long-term outcomes. Keywords : Aneurysms, Hemorrhage, Clipping, Microsurgical removal

Corresponding author : Mihai-Stelian MOREANU, moreanumihai@yahoo.com