[Diagnosis and management of intracranial aneurysm in children].

OBJECTIVE: To describe the clinical manifestations of intracranial aneurysm in children and to evaluate the efficacy and safety of different therapeutic approaches for children with intracranial aneurysms. METHODS: Clinical data of 23 pediatric patients with intracranial aneurysms diagnosed and treated at our hospital over the past 18 years were retrospectively reviewed. Follow-up data were also collected and analyzed. RESULTS: Two patients received no further treatment. Surgery was performed in 16 patients. Among them, 15 achieved an excellent recovery and 1 died. 5 patients were treated with Guglielmi detachable coil (GDC). Aneurysm was successfully sealed off in one case and an excellent recovery achieved; remnant aneurysm was detected in two cases. One received trapping while another underwent aneurysmectomy. The patient died postoperatively. Another received neck clipping and resection. And the patient recovered well; two cases experienced aneurysm recanalization after interventional therapy. Among them, one received a second embolotherapy but it became recanalized again. And it was finally cured by aneurysmectomy. CONCLUSION: Aneurysm surgery is proved to be a safe and effective treatment for children with intracranial aneurysm. Endovascular treatment of intracranial aneurysms with GDC is also shown to be effective and safe for pediatric patient with acute SAH. But a long-term follow-up study is required to determine the clinical outcome. Once a aneurysm remnant or recanalization occurs, a microsurgical management is recommended.