Abstract 166: Comparative Outcome of Intracranial Dissecting Aneurysms Treated by Endovascular and Surgical Treatment following intracranial hemorrhage

Abstract

Introduction intracranial dissecting aneurysm in pediatric age group is uncommon and very few studies are available comparing outcome following endovascular and surgery. The primary objective of this study was to evaluate the clinico‐radiological characteristics of intracranial dissecting aneurysms (IDAs) in childhood and assess the treatment outcomes associated with this condition. Methods A retrospective analysis was performed on pediatric patients who received treatment for spontaneous IDAs at our institution between January 2019 and December 2023. Detailed examinations of clinical presentation, aneurysm features, treatment modalities, and patient outcomes were conducted. Results The study involved 25 pediatric patients with IDAs, with a mean age of 12.4 ± 4.9 years (range, 3–15 years), comprising 25% of all treated intracranial aneurysms in pediatric cases during the specified period. Among them, 15 (60%) were male and 10 (40%) were female. The incidence of large (≥10 mm) or giant (≥25 mm) aneurysms was 40%. Endovascular treatment was administered to 11 (44%) patients, surgical treatment to 9 (36%) patients, and 5 (20%) patients received conservative treatment. Perioperative complications occurred in 2 patients treated with endovascular and 3 patients treated surgically (p = 0.21). Out of those treated with endovascular intervention, two patients achieved full recovery with a Glasgow Outcome Scale (GOS) score of 5, and one patient treated surgically recovered with a GOS score of 4. Overall, 22 (88%) patients experienced a favorable outcome, while three (12%) had an unfavorable outcome during a mean follow‐up of 22.32 ± 7.43 months (range, 6–55 months). Conclusion Pediatric IDAs are infrequent occurrences. In this specific series, endovascular management emerged as a relatively safe and effective treatment approach for pediatric IDAs. However, continued follow‐up is essential due to the potential risk of aneurysm recurrence and de novo aneurysm formation following treatment.