Sun Jingxuan,Zhang RongTing,Yang Yuhao,et al.Traumatic intracranial aneurysms in children: a report of 2 cases with a literature review[J].Journal of Clinical Pediatric Surgery,2025,(02):138-142.[doi:10.3760/cma.j.cn101785-202412041-007]
Traumatic intracranial aneurysms in children: a report of 2 cases with a literature review
- Keywords:
- Traumatic Intracranial Aneurysm; Signs and Symptoms; Diagnosis; Endovascular Therapy; Embolization; Therapeutic; Treatment Outcome; Child; Consensus Development Conference
- Abstract:
- Objective To explore the clinical characteristics and therapeutic approaches for pediatric traumatic intracranial aneurysm (TICA). Methods A retrospective analysis was conducted for the relevant clinical data of TICA children with varying degrees of consciousness disturbance between January 2020 and December 2023.Also a literature review was performed for retrieving the relevant articles on pediatric TICA from PubMed,Wanfang Medical Network and China National Knowledge Infrastructure (CNKI) from January 1993 to December 2023.The incidence,clinical manifestations,diagnostic and therapeutic procedures of TICA were systematically examined.And modified Rankin Scale (mRS) was utilized for assessing the clinical outcomes of children at their last postoperative follow-up. Results The causes were head trauma (n=1) and iatrogenic injury (n=1).Upon admission,TICA was diagnosed via computed tomography angiography (CTA) and digital subtraction angiography (DSA).Interventional embolization therapy was performed.At the last follow-up,1 case exhibited a favorable prognosis (mRS 0-1) with no residual neurological dysfunction while another case developed hemiplegia of one limb (mRS 2-3).Among the retrieved literature,48 articles fulfilled the exclusion criteria,including 6 Chinese and 42 English articles.Among a total of 69 cases,there were 41 boys and 26 girls with a boy-to-girl ratio of 1.6∶1.Traffic accidents were identified as the most common cause (23/69,33.3%) and consciousness disturbance dominated (26/69,37.7%).Subarachnoid hemorrhage was a primary manifestation on initial cranial computed tomography (CT) upon admission (38/69,55.1%).A large majority of aneurysms were located in anterior circulation (48/69,69.6%),largely cystic in nature (52/69,75.4%) and had a high rupture rate (48/69,69.6%).Interventional therapy was the most frequently chosen treatment modality (51/69,73.9%).And most children exhibited a favorable prognosis after treatment (45/69,65.2％). Conclusions Pediatric traumatic aneurysms are infrequent in clinical practices and tend to have atypical symptoms.A comprehensive diagnosis should be made through integrating medical history and auxiliary examinations.
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Memo
收稿日期:2024-12-15。
基金项目:国家自然科学基金(81902972)
通讯作者:杨天权,Email:szdxytq@suda.edu.cn