Giant intracranial aneurysms in the paediatric population: Suggested management and a review of the literature
Résumé
Objectives
Intracranial aneurysms are rare in children although giant aneurysms more commonly occur in adolescence. The aims of our study were to perform an extensive review of the literature over the past two decades and assess intracranial aneurysm management.
Methods
Based on a Pubmed search, we carried out a review of the literature from 1990 to 2012 regarding giant intracranial aneurysms diagnosed in the paediatric population. This descriptive study concerned clinical presentation, cerebral aneurysm characteristics, therapeutic management procedures and outcome.
Results
Forty-six cases were reported in 31 papers. The male/female sex ratio was 1.15, the clinical presentation was a tumour mass syndrome in 56.6%, followed by rupture in 30.4%. The aneurysm location was the posterior circulation in 41.3%, and microsurgical treatment (52.2%) predominated over endovascular coiling (28.3%).
Conclusion
To date, no evidence-based medicine recommendation has been accepted for the management of rare intracranial aneurysms. Each reported patient was the object of a multidisciplinary clinical decision. Management of this challenging pathology should be performed on a case-to-case basis.
Les anévrismes géants de l’enfant, exceptionnels, sont rapportés uniquement sous forme d’observations. L’objectif de ce travail était de réaliser une revue exhaustive des publications sur le sujet afin de mieux définir cette situation clinique qui constitue un challenge thérapeutique.