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  • Baltimore Brain Aneurysm Foundation Support Group

    Lutherville-Timonium, MD

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  • Bay Area Aneurysm and Vascular Malformation Support Group

    San Francisco, CA

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  • Beth Israel Deaconess Brain Aneurysm Support Group

    Boston, MA

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Pediatric Aneurysms

Aneurysms in children under 18 years of age are rare. In contrast to adults, brain aneurysms in children occur more often in males than in females (by a 1:8 to 1 ratio). This suggests that the formation of pediatric brain aneurysms is different than that of adults.

Pediatric brain aneurysms are not as well understood as brain aneurysms in adults. However, it has been observed that approximately 20 percent of aneurysms in children are so-called giant aneurysms (larger than 2.5 cm in diameter), and that children are four times more likely to present with subarachnoid hemorrhage (SAH) than without SAH. Fortunately, with improvements in brain imaging techniques, increasing numbers of children with brain aneurysms are being diagnosed before their aneurysm ruptures.

Although they can occur with no known cause, aneurysms in children are commonly associated with severe head trauma, connective tissue disorders, or infection. A tendency to develop aneurysms can sometimes run in families or can occur as part of a genetic disorder, such as Marfan syndrome, Ehlers-Danlos syndrome, or autosomal dominant polycystic kidney disease.

As with adults, the treatment options for pediatric patients include open surgery (clipping), endovascular therapies (such as coiling), or careful observation. The decision about treatment, or even whether to treat, is based on a careful analysis of the risks and benefits. It is important that children who have been diagnosed with an aneurysm diligently maintain long-term follow-up with their medical team.

Pediatric Aneurysms

Intracranial Aneurysms In Children (<18 Years Old) Are Rare

  • Reported prevalence ranging from .5% to 4.6%
  • Epidemiology poorly understood
  • Pediatric brain aneurysms occur more often in male patients
  • Male/ female occurrence is 1.8: 1
  • Subarachnoid hemorrhage was the most common presentation in 80% of the children
  • The most common overall location was the ICA terminus, which was the location in 26% of the cases
  • Only 17% occurred in the posterior circulation
  • One fifth of all aneurysms were giant lesions
  • The sex predominance (male/ female 1.8:1) may suggest the existence of differences in pathogenesis of aneurysm formation in the pediatric patient
  • One interpretation is that congenital factors present in all aneurysm patients may be expressed more in boys, but environmental factors may contribute to the increased incidence in girls
  • Aneurysms in the pediatric population are four times as likely to present with subarachnoid hemorrhage versus without subarachnoid hemorrhage
  • Pediatric aneurysms are twice as likely to be of a better grade
  • Of the published series of pediatric aneurysms, almost all the earliest series before 1981 were comprised of subarachnoid hemorrhage patients. Unruptured aneurysms were detected more often thereafter, a reflection in the improvement of neuroimaging techniques.
  • Posterior circulation aneurysms accounted for 17% of all pediatric aneurysms.
    Click here for our Youth Fact Sheet on brain aneurysms
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