Diagnostic characteristics, management and clinical outcomes of intracranial aneurysms in pediatric population

Aim: Pediatric intracranial aneurysms are rare and differ from adult aneurysms in terms of aneurysm characteristics and clinical course. This study aims to retrospectively evaluate the characteristics, treatment approaches, and outcomes of pediatric aneurysms treated with endovascular methods in our center, and to contribute to the development of treatment and follow-up strategies by gaining a better understanding of this rare condition. Material and Method: The study included 35 patients under the age of 18 who presented to our center between 2004 and 2024 and were diagnosed with intracranial aneurysms and treated with endovascular methods. The clinical characteristics, pre- and post-treatment radiological and neurological statuses, and follow-up results of all cases were evaluated. Results: A total of 35 patients were evaluated, with 54% being male and 46% being female. Dissecting aneurysms were the most common (51.4%). 73% of aneurysms were in the anterior circulation, most commonly the ICA and MCA. The most common treatment options were coil embolization, aneurysm embolization with parent artery occlusion, and flow-diverting stents. The mean follow-up was 4.7 years, and complete occlusion was detected in 83.3% of aneurysms. At follow-up, 96.8% of patients had a positive Modified Rankin score. Conclusion: Pediatric intracranial aneurysms are rare and tend to be more complex than those in adults. However, childhood aneurysms have a better prognosis than those in adults. Endovascular treatment is considered safe and is preferred in appropriate cases. Treatment for this group of aneurysms should be determined and performed on a case-by-case basis by a multidisciplinary team. Keywords: Endovascular aneurysm repair, intracranial aneurysm, pediatrics