Evidence map›Paper›PMID 38635071›Full record

SynthesisChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2024

Treatment of pediatric intracranial aneurysms: institutional case series and systematic literature review.

Michael G Brandel, Jillian H Plonsker, Robert C Rennert, Gautam Produturi, Megana Saripella, Arvin R Wali, Carson McCann, Vijay M Ravindra, David R Santiago-Dieppa, J Scott Pannell and 3 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Neuro-interventional Radiology in Paediatric Patients: An Update.Cardiovascular and interventional radiology · 2025
    Review
  4. Article
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Michael G BrandelDepartment of Neurosurgery, University of California, San Diego-Rady Children's Hospital, San Diego, CA, USA.
Jillian H PlonskerDepartment of Neurosurgery, University of California, San Diego-Rady Children's Hospital, San Diego, CA, USA.
Robert C RennertDepartment of Neurosurgery, University of Utah, 175 North Medical Drive East, Salt Lake City, CA, USA.
Gautam ProduturiSchool of Medicine, University of California, San Diego, CA, USA.
Megana SaripellaSchool of Medicine, University of California, San Diego, CA, USA.
Arvin R WaliDepartment of Neurosurgery, University of California, San Diego-Rady Children's Hospital, San Diego, CA, USA.
Carson McCannSchool of Medicine, University of California, San Diego, CA, USA.
Vijay M RavindraDepartment of Neurosurgery, University of California, San Diego-Rady Children's Hospital, San Diego, CA, USA.
David R Santiago-DieppaDepartment of Neurosurgery, University of California, San Diego-Rady Children's Hospital, San Diego, CA, USA.
J Scott PannellDepartment of Neurosurgery, University of California, San Diego-Rady Children's Hospital, San Diego, CA, USA.
Jeffrey A SteinbergDepartment of Neurosurgery, University of California, San Diego-Rady Children's Hospital, San Diego, CA, USA.
Alexander A KhalessiDepartment of Neurosurgery, University of California, San Diego-Rady Children's Hospital, San Diego, CA, USA.
Michael L LevyDepartment of Neurosurgery, University of California, San Diego-Rady Children's Hospital, San Diego, CA, USA. mlevy@rchsd.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPediatric intracranial aneurysms (IAs) are rare and have distinct clinical profiles compared to adult IAs. They differ in location, size, morphology, presentation, and treatment strategies. We present our experience with pediatric IAs over an 18-year period using surgical and endovascular treatments and review the literature to identify commonalities in epidemiology, treatment, and outcomes.

methodsWe identified all patients < 20 years old who underwent treatment for IAs at our institution between 2005 and 2020. Medical records and imaging were examined for demographic, clinical, and operative data. A systematic review was performed to identify studies reporting primary outcomes of surgical and endovascular treatment of pediatric IAs. Demographic information, aneurysm characteristics, treatment strategies, and outcomes were collected.

resultsThirty-three patients underwent treatment for 37 aneurysms over 18 years. The mean age was 11.4 years, ranging from one month to 19 years. There were 21 males (63.6%) and 12 females (36.4%), yielding a male: female ratio of 1.75:1. Twenty-six (70.3%) aneurysms arose from the anterior circulation and 11 (29.7%) arose from the posterior circulation. Aneurysmal rupture occurred in 19 (57.5%) patients, of which 8 (24.2%) were categorized as Hunt-Hess grades IV or V. Aneurysm recurrence or rerupture occurred in five (15.2%) patients, and 5 patients (15.2%) died due to sequelae of their aneurysms. Twenty-one patients (63.6%) had a good outcome (modified Rankin Scale score 0-2) on last follow up. The systematic literature review yielded 48 studies which included 1,482 total aneurysms (611 with endovascular treatment; 656 treated surgically; 215 treated conservatively). Mean aneurysm recurrence rates in the literature were 12.7% and 3.9% for endovascular and surgical treatment, respectively.

conclusionsOur study provides data on the natural history and longitudinal outcomes for children treated for IAs at a single institution, in addition to our treatment strategies for various aneurysmal morphologies. Despite the high proportion of patients presenting with rupture, good functional outcomes can be achieved for most patients.

Indexed as

Endovascular ProceduresIntracranial AneurysmAdolescentChildChild, PreschoolFemaleHumansInfantMaleNeurosurgical ProceduresTreatment OutcomeYoung AdultCerebral aneurysmClippingCoilingEndovascularFlow diversionOutcomes

Identifiers

PMID38635071
PMCPMC11269470

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.