Pediatric intracranial aneurysms: considerations and recommendations for follow-up imaging
Department of Radiology
Nervous System Diseases | Neurology | Pediatrics | Radiology
BACKGROUND: Pediatric intracranial aneurysms (IAs) are rare. Compared to adult IAs, they are more commonly giant, fusiform, or dissecting. Their treatment often proves more complex and recurrence rate and de novo aneurysmogenesis incidence is higher. A consensus regarding the most appropriate algorithm for following pediatric IAs is lacking.
METHODS: We thus sought to generate recommendations based on the reported experience in the literature with pediatric IAs, through a thorough review of the Pubmed database, discussion with experienced neurointerventionalists, and our own experience.
RESULTS: and Conclusions: We propose incidental untreated IAs to be followed by magnetic resonance angiography (MRA) without contrast. Follow-up modality and interval for treated pediatric IAs is determined by initial aneurysmal complexity, treatment modality, and degree of post-treatment obliteration. Recurrence or de novo aneurysmogenesis requiring treatment should be followed by DSA and appropriate re-treatment. Computed tomographic angiography is preferred for clipped IAs while contrast-enhanced MRA is preferred for endovascularly-treated lesions with coil embolization and those treated microsurgically in a manner other than clipping.
CTA, DSA, MRA, aneurysms, imaging, intracranial, pediatric
DOI of Published Version
World Neurosurg. 2018 Jan;109:418-431. doi: 10.1016/j.wneu.2017.09.150. Epub 2017 Oct 3. Link to article on publisher's site
Ghali M, Srinivasan VM, Cherian J, Kim L, Siddiqui A, Aziz-Sultan MA, Froehler M, Wakhloo AK, Savageau E, Rai A, Chen SR, Johnson J, Lam SK, Kan P. (2018). Pediatric intracranial aneurysms: considerations and recommendations for follow-up imaging. Radiology Publications. https://doi.org/10.1016/j.wneu.2017.09.150. Retrieved from https://escholarship.umassmed.edu/radiology_pubs/356