Discover the critical insights on the rupture risks and patient outcomes associated with giant aneurysms in children, as we delve into a comprehensive multi-institutional case series and systematic review.
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Rupture risk and outcomes of giant aneurysms in pediatric patients: a multi-institutional case series and systematic review.
Gupta et al., J Neurosurg Pediatr 2023
DOI: 10.3171/2023.10.PEDS23296
New Insights:
This study provides a comprehensive analysis of giant aneurysms in pediatric patients, highlighting the clinical course and outcomes. It emphasizes the rarity of these aneurysms and the need for treatment, given the significant risk of neurological morbidity and mortality.
Importance:
The research is important as it consolidates data from multiple institutions and previously reported cases, offering a larger cohort for analysis than typically available. This allows for more robust statistical evaluation and understanding of the condition.
Contribution to Literature:
The study contributes to the literature by identifying specific risk factors for aneurysm rupture in this population, such as posterior circulation location and younger age. It also quantifies outcomes, showing a high survival rate and a majority achieving favorable neurological outcomes, especially with unruptured aneurysms and endovascular treatment.
Results Summary:
– Pooled cohort: 103 pediatric patients with giant aneurysms.
– Common locations: Middle cerebral artery (36%), internal carotid artery (27%).
– Rupture rates: 28% overall; higher in posterior circulation aneurysms (44%).
– Risk factors for rupture: Posterior circulation location (OR 2.66) and younger age (OR 0.90 per year).
– Treatment: 97% of cases; endovascular treatment associated with favorable outcomes (OR 5.05).
– Outcomes: Mortality 3% in unruptured, 18% in ruptured; favorable neurological outcomes in 80% of unruptured, 54% of ruptured cases.