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.