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J Neurointerv Surg. 2019 Mar;11(3):257-264. doi: 10.1136/neurintsurg-2018-014001. Epub 2018 Aug 12.

Treatment of pediatric intracranial aneurysms: case series and meta-analysis.

Author information

1
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri, USA.
2
School of Medicine, University of Missouri-Columbia, Columbia, Missouri, USA.
3
Department of Neurological Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
4
Department of Neurology, Washington University School of Medicine, St Louis, Missouri, USA.

Abstract

BACKGROUND:

There are limited outcome data to guide the choice of treatment in pediatric patients with cerebral aneurysms.

OBJECTIVE:

To describe our institutional experience treating pediatric patients with cerebral aneurysms and to conduct a meta-analysis of available studies to provide the best current evidence on treatment related outcomes.

METHODS:

We identified pediatric patients with cerebral aneurysms evaluated or treated at our institution using a comprehensive case log. We also identified studies to include in a meta-analysis through a systematic search of Pubmed, SCOPUS, EMBASE, and the Cochrane Database of Systematic Reviews. As part of both the local analysis and meta-analysis, we recorded patient characteristics, aneurysm characteristics, management, and outcomes. Statistical analysis was performed using Fisher's exact test and the two tailed Student's t test, as appropriate.

RESULTS:

42 pediatric patients with 57 aneurysms were evaluated at our institution, and treatment specific outcome data were available in 560 patients as part of our meta-analysis. Endovascular and surgical treatments yielded comparable rates of favorable outcome in all children (88.3% vs 82.7%, respectively, P=0.097), in children with ruptured aneurysms (75% vs 83%, respectively, P=0.357), and in children with unruptured aneurysms (96% vs 97%, respectively, P=1.000).

CONCLUSION:

Endovascular and surgical treatment yield comparable long term clinical outcomes in pediatric patients with cerebral aneurysms.

KEYWORDS:

aneurysm; hemorrhage; pediatrics; subarachnoid

PMID:
30100557
DOI:
10.1136/neurintsurg-2018-014001
[Indexed for MEDLINE]

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