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February 1974, Vol 127, No. 2 >
Article | February 1974

Intracranial Arterial Aneurysms in Childhood FREE

William A. Shucart, MD; Samuel M. Wolpert, MD
[+] Author Affiliations

Received for publication April 11, 1973; accepted July 28.

Reprint requests to Department of Neurosurgery, Tufts-New England Medical Center, 171 Harrison Ave, Boston 02111 (Dr. Shucart).


Am J Dis Child. 1974;127(2):288-293. doi:10.1001/archpedi.1974.02110210138022.
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References
Comments

Intracranial arterial aneurysms are an increasingly frequent problem in children. In this article we present a discussion of the pathology, clinical presentation, complications, and treatment, as well as a brief consideration of the differential diagnosis of spontaneous subarachnoid hemorrhage.

REFERENCES

1 +
Sahs AL, et al: Intracranial Aneurysms and Subarachnoid Hemorrhage: A cooperative Study . Philadelphia, JB Lippincott Co, 1969;.
2 +
Padgett DH:  The development of the cranial arteries in the human embryo . Contrib Embryol Carnegie Inst 32:205-261, 1948;.
3 +
Sugar O:  Pathological anatomy and angiography of intracranial vascular anomalies . J Neurosurg 8:3-22, 1951;.
4 +
Forbus WD:  On the origin of miliary aneurysms of the superficial cerebral arteries . Bull Johns Hopkins Hosp 47:239-284, 1930;.
5 +
Forster FM, Alpers BJ:  Anatomical defects and pathological changes in congenital cerebral aneurysms . J Neuropathol Exp Neurol 4:146-154, 1945;.
6 +
Smith DE, Windsor RB, in Fields WS (ed): Pathogenesis and Treatment of Cerebrovascular Disease . Springfield, Ill, Charles C Thomas Publisher, 1961;, p 367.
7 +
Dial DL, Maurer GB:  Intracranial aneurysms . Am J Surg 35:2-21, 1937;.
8 +
Housepian EM, Pool JL:  Systematic analysis of intracranial aneurysms from the autopsy file of the Presbyterian Hospital, 1914-1956 . J Neuropathol Exp Neurol 17:409-423, 1958;.
9 +
McDonald CA, Korb M:  Intracranial aneurysms . Arch Neurol Psychiatry 42:298-328, 1939;.
10 +
Patel AN, Richardson AE:  Ruptured intracranial aneurysms in the first two decades of life . J Neurosurg 35:571-576, 1971;.
11 +
Boyd-Wilson JS:  The association of cerebral angiomas with intracranial aneurysms . J Neurol Neurosurg Psychiatry 22:218-223, 1959;.
12 +
Brown AP:  Polycystic diseases of the kidneys and intracranial aneurysms; the etiology and interrelation of these conditions: Review of recent literature and report of seven cases in which both conditions coexisted . Glasgow Med J 32:333-348, 1951;.
13 +
Dalgaard OZ: Bilateral Polycystic Disease of the Kidneys: A Follow-up of Two Hundred and Eighty-Four Patients and Their Families . Copenhagen, Munksgaard, 1957;.
14 +
Forster FM, Alpers BJ:  Aneurysm of circle of Willis associated with congenital polycystic disease of the kidneys . Arch Neurol Psychiatry 50:669-676, 1943;.
15 +
Matson DD:  Intracranial arterial aneurysms in childhood . J Neurosurg 23:578-580, 1965;.
16 +
Reifenstein GH, Levine SA, Gross RE:  Coarctation of the aorta: A review of 104 autopsied cases of "adult type," two years of age or older . Am Heart J 33:146-168, 1947;.
17 +
Schwartz MJ, Baronofsky ID:  Ruptured intracranial aneurysm associated with coarctation of the aorta: Report of a patient treated by hypothermia and surgical repair of the coarctation . Am J Cardiol 6:982-988, 1960;.
18 +
Garcia-Chavez C, Moosy J:  Cerebral artery aneurysm in infancy: Association with agenesis of the corpus callosum . J Neuropathol Exp Neurol 24:492-501, 1965;.
19 +
Pool JL, Potts DG: Aneurysms and Arteriovenous Anomalies of the Brain: Diagnosis and Treatment . New York, Harper & Row, 1965;, p 57.
20 +
Bailey OT, in Minckler U (ed): Pathology of the Nervous System . New York, McGraw-Hill Book Co Inc, 1971;, vol 2.
21 +
Dratz H, Woodhall B:  Traumatic dissecting aneurysm of left internal carotid, anterior cerebral, and middle cerebral arteries . J Neuropathol Exp Neurol 6:286-291, 1947;.
22 +
Wolman L:  Cerebral dissecting aneurysms . Brain 82:276-291, 1959;.
23 +
Wolpert SM, Schechter MM:  Traumatic middle cerebral artery occlusion . Radiology 87:671-677, 1966;.
24 +
Devadiga KV, Mathai KV, Chandy J:  Spontaneous cure of intracavernous aneurysm of the internal carotid artery in a 14-month old child . J Neurosurg 30:165-168, 1969;.
25 +
Thompson RA, Pribam HFW:  Infantile cerebral aneurysm associated with ophthalmoplegia and quadriparesis . Neurology 19:785-789, 1969;.
26 +
Shucart WA, Wolpert SM:  An aneurysm in infancy presenting with diabetes insipidus . J Neurosurg 37:368-371, 1972;.
27 +
Jane JA:  A large aneurysm of the posterior-inferior cerebellar artery in a one-year old child . J Neurosurg 18:245-247, 1961;.
28 +
Lemmen LJ, Schneider RC:  Aneurysm in the third ventricle . Neurology 3:474-476, 1953;.
29 +
Merritt HH: A Textbook of Neurology . Philadelphia, Lea & Febiger, 1967;, p 208.
30 +
Pool JL:  Cerebral vasospasm . N Engl J Med 259:1259-1264, 1958;.
31 +
Fletcher TM, Taveras JM, Pool JL:  Cerebral vasospasm in angiography for intracranial aneurysms: Incidence and significance in 100 consecutive angiograms . Arch Neurol 1:38-47, 1959;.
32 +
Lagos JC, Siekert RG,  Intracranial hemorrhage in infancy and childhood . Clin Pediatr 8:90-97, 1969;.
33 +
Ritchie WP, Haines G:  Spontaneous intracranial hemorrhage in children: Report of eight cases in children fifteen years of age or younger . Arch Surg 66:452-460, 1953;.
34 +
Matson DD: Neurosurgery in Infancy and Childhood , ed 2. Springfield, Charles C Thomas Publisher, 1969;, p 754.
35 +
Sedzmir CB, Ribinson J:  Intracranial hemorrhage in children and adolescents . J Neurosurg 38:269-281, 1973;.
36 +
Banker BQ:  Cerebral vascular disease in infancy and childhood: I. Occlusive vascular disease . J Neuropathol Exp Neurol 20:127-240, 1961;.
37 +
Krayenbuhl HA:  Cerebral venous and sinus thrombosis . Clin Neurosurg 14:1-24, 1967;.
38 +
Wood EH:  Angiographic identification of ruptured lesion in patients with multiple cerebral aneurysms . J Neurosurg 21:182-198, 1964;.
39 +
Mullan S, Dawley J:  Antifibrinolytic therapy for intracranial aneurysms . J Neurosurg 28:21-23, 1968;.
40 +
Williams RR, Bahn RC, Sayre GP:  Congenital cerebral aneurysms . Proc Staff Meet Mayo Clinic 30:161-168, 1955;.
41 +
Boop WC Jr, Chan WN, French LA:  Ruptured intracranial aneurysm complicated by subdural hematoma . J Neurosurg 18:834-836, 1961;.
42 +
Foltz EL, Ward AA Jr:  Communicating hydrocephalus from subarachnoid bleeding . J Neurosurg 13:546-566, 1956;.
43 +
Pakarinen S:  Incidence, aetiology, and prognosis of primary subarachnoid haemorrhage: A study based on 589 cases diagnosed in a defined urban population during a defined period . Acta Neurol Scand 43( (suppl 29) ):1-28, 1967;.
44 +
Jefferson G:  Subarachnoid hemorrhage from angiomas and aneurysms in the young . Rev Neurol 80:413-432, 1948;.
45 +
Tappura M: Prognosis of Subarachnoid Hemorrhage . Helsinki, Mercatorin Kirjapaino, 1962;.
46 +
McKissock W, Paine KWE, Walsh LS:  Analysis of results of treatment of ruptured intracranial aneurysms: report of 772 consecutive cases . J Neurosurg 17:762-776, 1960;.
47 +
Winn HR, Jane JA, Richardson AE: Late morbidity and mortality in cerebral aneurysm. Read before the American Neurological Association Meeting, June 12, 1973.
48 +
Arai H, et al:  Multiple intracranial aneurysms and vascular malformations in an infant . J Neurosurg 37:357-360, 1972;.
49 +
Hermann K, MacGregor AR:  Cerebral hemorrhage from rupture of a congenital intracerebral aneurysm in a child . Br Med J 1:523-525, 1940;.
50 +
Johes RK, Shearburn EW:  Intracranial aneurysm in a four-week old infant . J Neurosurg 18:122-124, 1961;.
51 +
Kimbell RD Jr, Llewellyn RE, Kirgis HD:  Surgical treatment of ruptured aneurysm with intracerebral and subarachnoid hemorrhage in a 16-month old infant . J Neurosurg 17:331-332, 1960;.
52 +
Newcomb AL, Munnes GF:  Rupture of aneurysm of the circle of Willis in the newborn . J Pediatr 3:769-772, 1949;.
53 +
Pickering LK, Hogan GR, Gilbert EF:  Aneurysm of the posterior-inferior cerebellar artery: Rupture in a newborn . Am J Dis Child 119:155-158, 1970;.
54 +
Vapalahti PM, et al:  Intracranial arterial aneurysm in a three-month old infant . J Neurosurg 30:169-171, 1969;.
55 +
Jacob JC, et al:  Uncommon cerebrovascular lesions in children . Develop Med Child Neurol 12:446-453, 1970;.
56 +
Riggs HE, Rupp C:  Miliary aneurysms: Relation of anomalies of the circle of Willis to aneurysm formation . J Neuropathol Exp Neurol 1:442, 1942;.
57 +
Thompson JR, Harwood-Nash DC, Fitz CR:  Cerebral aneurysms in children . Am J Roentgenol 118:163-175, 1973;.

Figures

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Sahs AL, et al: Intracranial Aneurysms and Subarachnoid Hemorrhage: A cooperative Study . Philadelphia, JB Lippincott Co, 1969;.
2 +
Padgett DH:  The development of the cranial arteries in the human embryo . Contrib Embryol Carnegie Inst 32:205-261, 1948;.
3 +
Sugar O:  Pathological anatomy and angiography of intracranial vascular anomalies . J Neurosurg 8:3-22, 1951;.
4 +
Forbus WD:  On the origin of miliary aneurysms of the superficial cerebral arteries . Bull Johns Hopkins Hosp 47:239-284, 1930;.
5 +
Forster FM, Alpers BJ:  Anatomical defects and pathological changes in congenital cerebral aneurysms . J Neuropathol Exp Neurol 4:146-154, 1945;.
6 +
Smith DE, Windsor RB, in Fields WS (ed): Pathogenesis and Treatment of Cerebrovascular Disease . Springfield, Ill, Charles C Thomas Publisher, 1961;, p 367.
7 +
Dial DL, Maurer GB:  Intracranial aneurysms . Am J Surg 35:2-21, 1937;.
8 +
Housepian EM, Pool JL:  Systematic analysis of intracranial aneurysms from the autopsy file of the Presbyterian Hospital, 1914-1956 . J Neuropathol Exp Neurol 17:409-423, 1958;.
9 +
McDonald CA, Korb M:  Intracranial aneurysms . Arch Neurol Psychiatry 42:298-328, 1939;.
10 +
Patel AN, Richardson AE:  Ruptured intracranial aneurysms in the first two decades of life . J Neurosurg 35:571-576, 1971;.
11 +
Boyd-Wilson JS:  The association of cerebral angiomas with intracranial aneurysms . J Neurol Neurosurg Psychiatry 22:218-223, 1959;.
12 +
Brown AP:  Polycystic diseases of the kidneys and intracranial aneurysms; the etiology and interrelation of these conditions: Review of recent literature and report of seven cases in which both conditions coexisted . Glasgow Med J 32:333-348, 1951;.
13 +
Dalgaard OZ: Bilateral Polycystic Disease of the Kidneys: A Follow-up of Two Hundred and Eighty-Four Patients and Their Families . Copenhagen, Munksgaard, 1957;.
14 +
Forster FM, Alpers BJ:  Aneurysm of circle of Willis associated with congenital polycystic disease of the kidneys . Arch Neurol Psychiatry 50:669-676, 1943;.
15 +
Matson DD:  Intracranial arterial aneurysms in childhood . J Neurosurg 23:578-580, 1965;.
16 +
Reifenstein GH, Levine SA, Gross RE:  Coarctation of the aorta: A review of 104 autopsied cases of "adult type," two years of age or older . Am Heart J 33:146-168, 1947;.
17 +
Schwartz MJ, Baronofsky ID:  Ruptured intracranial aneurysm associated with coarctation of the aorta: Report of a patient treated by hypothermia and surgical repair of the coarctation . Am J Cardiol 6:982-988, 1960;.
18 +
Garcia-Chavez C, Moosy J:  Cerebral artery aneurysm in infancy: Association with agenesis of the corpus callosum . J Neuropathol Exp Neurol 24:492-501, 1965;.
19 +
Pool JL, Potts DG: Aneurysms and Arteriovenous Anomalies of the Brain: Diagnosis and Treatment . New York, Harper & Row, 1965;, p 57.
20 +
Bailey OT, in Minckler U (ed): Pathology of the Nervous System . New York, McGraw-Hill Book Co Inc, 1971;, vol 2.
21 +
Dratz H, Woodhall B:  Traumatic dissecting aneurysm of left internal carotid, anterior cerebral, and middle cerebral arteries . J Neuropathol Exp Neurol 6:286-291, 1947;.
22 +
Wolman L:  Cerebral dissecting aneurysms . Brain 82:276-291, 1959;.
23 +
Wolpert SM, Schechter MM:  Traumatic middle cerebral artery occlusion . Radiology 87:671-677, 1966;.
24 +
Devadiga KV, Mathai KV, Chandy J:  Spontaneous cure of intracavernous aneurysm of the internal carotid artery in a 14-month old child . J Neurosurg 30:165-168, 1969;.
25 +
Thompson RA, Pribam HFW:  Infantile cerebral aneurysm associated with ophthalmoplegia and quadriparesis . Neurology 19:785-789, 1969;.
26 +
Shucart WA, Wolpert SM:  An aneurysm in infancy presenting with diabetes insipidus . J Neurosurg 37:368-371, 1972;.
27 +
Jane JA:  A large aneurysm of the posterior-inferior cerebellar artery in a one-year old child . J Neurosurg 18:245-247, 1961;.
28 +
Lemmen LJ, Schneider RC:  Aneurysm in the third ventricle . Neurology 3:474-476, 1953;.
29 +
Merritt HH: A Textbook of Neurology . Philadelphia, Lea & Febiger, 1967;, p 208.
30 +
Pool JL:  Cerebral vasospasm . N Engl J Med 259:1259-1264, 1958;.
31 +
Fletcher TM, Taveras JM, Pool JL:  Cerebral vasospasm in angiography for intracranial aneurysms: Incidence and significance in 100 consecutive angiograms . Arch Neurol 1:38-47, 1959;.
32 +
Lagos JC, Siekert RG,  Intracranial hemorrhage in infancy and childhood . Clin Pediatr 8:90-97, 1969;.
33 +
Ritchie WP, Haines G:  Spontaneous intracranial hemorrhage in children: Report of eight cases in children fifteen years of age or younger . Arch Surg 66:452-460, 1953;.
34 +
Matson DD: Neurosurgery in Infancy and Childhood , ed 2. Springfield, Charles C Thomas Publisher, 1969;, p 754.
35 +
Sedzmir CB, Ribinson J:  Intracranial hemorrhage in children and adolescents . J Neurosurg 38:269-281, 1973;.
36 +
Banker BQ:  Cerebral vascular disease in infancy and childhood: I. Occlusive vascular disease . J Neuropathol Exp Neurol 20:127-240, 1961;.
37 +
Krayenbuhl HA:  Cerebral venous and sinus thrombosis . Clin Neurosurg 14:1-24, 1967;.
38 +
Wood EH:  Angiographic identification of ruptured lesion in patients with multiple cerebral aneurysms . J Neurosurg 21:182-198, 1964;.
39 +
Mullan S, Dawley J:  Antifibrinolytic therapy for intracranial aneurysms . J Neurosurg 28:21-23, 1968;.
40 +
Williams RR, Bahn RC, Sayre GP:  Congenital cerebral aneurysms . Proc Staff Meet Mayo Clinic 30:161-168, 1955;.
41 +
Boop WC Jr, Chan WN, French LA:  Ruptured intracranial aneurysm complicated by subdural hematoma . J Neurosurg 18:834-836, 1961;.
42 +
Foltz EL, Ward AA Jr:  Communicating hydrocephalus from subarachnoid bleeding . J Neurosurg 13:546-566, 1956;.
43 +
Pakarinen S:  Incidence, aetiology, and prognosis of primary subarachnoid haemorrhage: A study based on 589 cases diagnosed in a defined urban population during a defined period . Acta Neurol Scand 43( (suppl 29) ):1-28, 1967;.
44 +
Jefferson G:  Subarachnoid hemorrhage from angiomas and aneurysms in the young . Rev Neurol 80:413-432, 1948;.
45 +
Tappura M: Prognosis of Subarachnoid Hemorrhage . Helsinki, Mercatorin Kirjapaino, 1962;.
46 +
McKissock W, Paine KWE, Walsh LS:  Analysis of results of treatment of ruptured intracranial aneurysms: report of 772 consecutive cases . J Neurosurg 17:762-776, 1960;.
47 +
Winn HR, Jane JA, Richardson AE: Late morbidity and mortality in cerebral aneurysm. Read before the American Neurological Association Meeting, June 12, 1973.
48 +
Arai H, et al:  Multiple intracranial aneurysms and vascular malformations in an infant . J Neurosurg 37:357-360, 1972;.
49 +
Hermann K, MacGregor AR:  Cerebral hemorrhage from rupture of a congenital intracerebral aneurysm in a child . Br Med J 1:523-525, 1940;.
50 +
Johes RK, Shearburn EW:  Intracranial aneurysm in a four-week old infant . J Neurosurg 18:122-124, 1961;.
51 +
Kimbell RD Jr, Llewellyn RE, Kirgis HD:  Surgical treatment of ruptured aneurysm with intracerebral and subarachnoid hemorrhage in a 16-month old infant . J Neurosurg 17:331-332, 1960;.
52 +
Newcomb AL, Munnes GF:  Rupture of aneurysm of the circle of Willis in the newborn . J Pediatr 3:769-772, 1949;.
53 +
Pickering LK, Hogan GR, Gilbert EF:  Aneurysm of the posterior-inferior cerebellar artery: Rupture in a newborn . Am J Dis Child 119:155-158, 1970;.
54 +
Vapalahti PM, et al:  Intracranial arterial aneurysm in a three-month old infant . J Neurosurg 30:169-171, 1969;.
55 +
Jacob JC, et al:  Uncommon cerebrovascular lesions in children . Develop Med Child Neurol 12:446-453, 1970;.
56 +
Riggs HE, Rupp C:  Miliary aneurysms: Relation of anomalies of the circle of Willis to aneurysm formation . J Neuropathol Exp Neurol 1:442, 1942;.
57 +
Thompson JR, Harwood-Nash DC, Fitz CR:  Cerebral aneurysms in children . Am J Roentgenol 118:163-175, 1973;.

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