Pediatric intracranial aneurysms: a different perspective

Abstract

In this retrospective study, Sanai and colleagues address the important issues of efficacy and durability of aneurysm obliteration after the treatment of pediatric intracranial aneurysms. The authors compare the results of microsurgery and endovascular therapy after the treatment of 43 aneurysms in 32 pediatric patients. The most significant findings of this study are as follows: 1) the reported superiority of microsurgery (rate of complete aneurysm obliteration, 94%) compared with endovascular treatment (rate of complete obliteration, 82%); and 2) the durability of treatment assessed in terms of aneurysm recurrence rate after microsurgery and endovascular treatment (0 and 14%, respectively). Compared with the adult population, the incidence of aneurysms in the pediatric population is low; 6‐8 however, the unique morphological characteristics of these lesions and the delicate intracranial anatomy and physiology of children with small blood vessels, infants in particular, present a management challenge to the involved surgeons. Unlike those in adults, aneurysms in children usually become symptomatic at the time of diagnosis. 1‐4,9 In terms of location, pediatric aneurysms have a predilection for the