Detection and Treatment Guide Updated 2017 Detection-and-Treatment-2017 | Page 9
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
(see “Familial Aneurysms,” page 7) 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.
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