Flow Diversion for Treatment of Growing A2 Aneurysm in a Child: Case Report and Review of Flow Diversion for Intracranial Aneurysms in Pediatric Patients

World Neurosurg. 2016 Dec;96:607.e13-607.e17. doi: 10.1016/j.wneu.2016.09.078. Epub 2016 Sep 29.

Abstract

Background: Intracranial flow diversion has gained increasing popularity since the approval of the Pipeline Embolization Device (PED). Although it is only approved for use in adult patients, the PED has been used to treat aneurysms in pediatric patients. We present the first reported case of the use of a PED in a pediatric patient to treat an unusual fusiform distal anterior cerebral artery aneurysm.

Case description: A 12-year-old girl presented with new onset seizures and was found to have a distal left anterior cerebral artery aneurysm. Initially, this was managed conservatively, but follow-up imaging performed 4 months after presentation demonstrated enlargement of the aneurysm. The patient underwent endovascular embolization of her aneurysm with PED. This was successfully performed and the patient recovered from the procedure with no neurologic deficits.

Conclusions: Follow-up digital subtraction angiography and magnetic resonance angiography at 6 and 12 months, respectively, showed complete occlusion of the aneurysm. We also reviewed the literature on flow diversion for treatment of pediatric intracranial aneurysms.

Keywords: Aneurysm; Flow diversion; Intracranial; Pediatric.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Angiography, Digital Subtraction
  • Cerebral Angiography
  • Child
  • Embolization, Therapeutic / instrumentation*
  • Female
  • Follow-Up Studies
  • Humans
  • Imaging, Three-Dimensional
  • Intracranial Aneurysm / diagnosis
  • Intracranial Aneurysm / surgery*
  • Magnetic Resonance Angiography
  • Postoperative Complications / diagnosis
  • Stents