Skip to main content
Top
Published in: Child's Nervous System 8/2008

01-08-2008 | Original Paper

Infectious intracranial aneurysms in the pediatric population: endovascular treatment with Onyx

Authors: Christopher S. Eddleman, Daniel Surdell, Arthur DiPatri Jr, Tadanori Tomita, Ali Shaibani

Published in: Child's Nervous System | Issue 8/2008

Login to get access

Abstract

Objects

Infectious intracranial aneurysms present a treatment challenge in the pediatric population. Current endovascular strategies and tools have been developed, which make treatment of infectious intracranial aneurysms with liquid embolics safe and effective. This study reviews the use of the liquid embolic Onyx in the treatment of infectious intracranial aneurysms in the pediatric population.

Materials and methods

We used an endovascular approach to treat ruptured infectious intracranial aneurysms. We embolized the aneurysms with either Onyx alone or in combination with platinum coils.

Conclusion

Endovascular therapy with liquid embolics (Onyx) has been shown to be a safe and effectual treatment option in the case of pediatric infectious intracranial aneurysms. The combination of endovascular modalities can also be used to tailor the therapeutic goal of exclusion of infectious aneurysms with good results. Further studies are needed to assess the long-term effectiveness of this approach to pediatric infectious intracranial aneurysms.
Literature
1.
go back to reference Agid R, Souza M, Reintamm G, Armstrong D, Dirks P, TerBugge K (2005) The role of endovascular treatment for pediatric aneurysms. Child’s Nerv Syst 21:6CrossRef Agid R, Souza M, Reintamm G, Armstrong D, Dirks P, TerBugge K (2005) The role of endovascular treatment for pediatric aneurysms. Child’s Nerv Syst 21:6CrossRef
2.
go back to reference Chun JY, Smith W, Halbach VV, Higashida RT, Wilson CB, Lawton MT (2001) Current multimodality management of infectious intracranial aneurysms. Neurosurgery 48:1203–1213 discussion 1213–1204PubMedCrossRef Chun JY, Smith W, Halbach VV, Higashida RT, Wilson CB, Lawton MT (2001) Current multimodality management of infectious intracranial aneurysms. Neurosurgery 48:1203–1213 discussion 1213–1204PubMedCrossRef
3.
go back to reference Cloft HJ, Kallmes DF, Jensen ME, Lanzino G, Dion JE (1999) Endovascular treatment of ruptured, peripheral cerebral aneurysms: parent artery occlusion with short Guglielmi detachable coils. Am J Neuroradiol 20:308–310PubMed Cloft HJ, Kallmes DF, Jensen ME, Lanzino G, Dion JE (1999) Endovascular treatment of ruptured, peripheral cerebral aneurysms: parent artery occlusion with short Guglielmi detachable coils. Am J Neuroradiol 20:308–310PubMed
4.
go back to reference Eddleman C, Nikas D, Shaibani A, Khan P, Dipatri AJ Jr, Tomita T (2007) HydroCoil embolization of a ruptured infectious aneurysm in a pediatric patient: case report and review of the literature. Child’s Nerv Syst 23:707–712CrossRef Eddleman C, Nikas D, Shaibani A, Khan P, Dipatri AJ Jr, Tomita T (2007) HydroCoil embolization of a ruptured infectious aneurysm in a pediatric patient: case report and review of the literature. Child’s Nerv Syst 23:707–712CrossRef
5.
go back to reference Erdogan HB, Erentug V, Bozbuga N, Goksedef D, Akinci E, Yakut C (2004) Endovascular treatment of intracerebral mycotic aneurysm before surgical treatment of infective endocarditis. Texas Heart Inst J 31:165–167 Erdogan HB, Erentug V, Bozbuga N, Goksedef D, Akinci E, Yakut C (2004) Endovascular treatment of intracerebral mycotic aneurysm before surgical treatment of infective endocarditis. Texas Heart Inst J 31:165–167
6.
go back to reference Florio F, Lauriola W, Nardella M, Strizzi V, Vallone S, Trossello MP (2003) Endovascular treatment of intracranial arterio-venous malformations with Onyx embolization: preliminary experience. Radiol Med (Torino) 106:512–520 Florio F, Lauriola W, Nardella M, Strizzi V, Vallone S, Trossello MP (2003) Endovascular treatment of intracranial arterio-venous malformations with Onyx embolization: preliminary experience. Radiol Med (Torino) 106:512–520
7.
go back to reference Frizzell RT, Vitek JJ, Hill DL, Fisher WS 3rd (1993) Treatment of a bacterial (mycotic) intracranial aneurysm using an endovascular approach. Neurosurgery 32:852–854PubMedCrossRef Frizzell RT, Vitek JJ, Hill DL, Fisher WS 3rd (1993) Treatment of a bacterial (mycotic) intracranial aneurysm using an endovascular approach. Neurosurgery 32:852–854PubMedCrossRef
8.
go back to reference Hara Y, Hosoda K, Wada T, Kimura H, Kohmura E (2006) Endovascular treatment for a unusually large mycotic aneurysm manifesting as intracerebral hemorrhage—case report. Neurol Med Chir (Tokyo) 46:544–547CrossRef Hara Y, Hosoda K, Wada T, Kimura H, Kohmura E (2006) Endovascular treatment for a unusually large mycotic aneurysm manifesting as intracerebral hemorrhage—case report. Neurol Med Chir (Tokyo) 46:544–547CrossRef
9.
go back to reference Kanaan I, Lasjaunias P, Coates R (1995) The spectrum of intracranial aneurysms in pediatrics. Minim Invasive Neurosurg 38:1–9PubMed Kanaan I, Lasjaunias P, Coates R (1995) The spectrum of intracranial aneurysms in pediatrics. Minim Invasive Neurosurg 38:1–9PubMed
10.
go back to reference Kannoth S, Iyer R, Thomas SV, Furtado SV, Rajesh BJ, Kesavadas C, Radhakrishnan VV, Sarma PS (2007) Intracranial infectious aneurysm: presentation, management and outcome. J Neurol Sci 256:3–9PubMedCrossRef Kannoth S, Iyer R, Thomas SV, Furtado SV, Rajesh BJ, Kesavadas C, Radhakrishnan VV, Sarma PS (2007) Intracranial infectious aneurysm: presentation, management and outcome. J Neurol Sci 256:3–9PubMedCrossRef
11.
go back to reference Karsner H (1946) Acute inflammation of arteries. Charles C Thomas, Springfield, IL Karsner H (1946) Acute inflammation of arteries. Charles C Thomas, Springfield, IL
12.
go back to reference Katakura K, Kayama T, Kondo R, Kureyama H, Maruya J, Nakajima M, Nakai O, Hosoya T, Yamaguchi K (1995) A case of multiple cerebral mycotic aneurysms treated with endovascular surgery. No Shinkei Geka 23:1127–1132PubMed Katakura K, Kayama T, Kondo R, Kureyama H, Maruya J, Nakajima M, Nakai O, Hosoya T, Yamaguchi K (1995) A case of multiple cerebral mycotic aneurysms treated with endovascular surgery. No Shinkei Geka 23:1127–1132PubMed
13.
go back to reference Khayata MH, Aymard A, Casasco A, Herbreteau D, Woimant F, Merland JJ (1993) Selective endovascular techniques in the treatment of cerebral mycotic aneurysms. Report of three cases. J Neurosurg 78:661–665PubMed Khayata MH, Aymard A, Casasco A, Herbreteau D, Woimant F, Merland JJ (1993) Selective endovascular techniques in the treatment of cerebral mycotic aneurysms. Report of three cases. J Neurosurg 78:661–665PubMed
14.
go back to reference Kundra SN (2003) Management of intracranial infectious aneurysms: a series of 16 cases. Neurosurgery 53:245–246 author reply 246PubMedCrossRef Kundra SN (2003) Management of intracranial infectious aneurysms: a series of 16 cases. Neurosurgery 53:245–246 author reply 246PubMedCrossRef
15.
go back to reference Lasjaunias P, Wuppalapati S, Alvarez H, Rodesch G, Ozanne A (2005) Intracranial aneurysms in children aged under 15 years: review of 59 consecutive children with 75 aneurysms. Child’s Nerv Syst 21:437–450CrossRef Lasjaunias P, Wuppalapati S, Alvarez H, Rodesch G, Ozanne A (2005) Intracranial aneurysms in children aged under 15 years: review of 59 consecutive children with 75 aneurysms. Child’s Nerv Syst 21:437–450CrossRef
16.
go back to reference Molinari GF, Smith L, Goldstein MN, Satran R (1973) Pathogenesis of cerebral mycotic aneurysms. Neurology 23:325–332PubMed Molinari GF, Smith L, Goldstein MN, Satran R (1973) Pathogenesis of cerebral mycotic aneurysms. Neurology 23:325–332PubMed
17.
go back to reference Nakahara I, Taha MM, Higashi T, Iwamuro Y, Iwaasa M, Watanabe Y, Tsunetoshi K, Munemitsu T (2006) Different modalities of treatment of intracranial mycotic aneurysms: report of 4 cases. Surg Neurol 66:405–409 discussion 409–410PubMedCrossRef Nakahara I, Taha MM, Higashi T, Iwamuro Y, Iwaasa M, Watanabe Y, Tsunetoshi K, Munemitsu T (2006) Different modalities of treatment of intracranial mycotic aneurysms: report of 4 cases. Surg Neurol 66:405–409 discussion 409–410PubMedCrossRef
18.
go back to reference Phuong LK, Link M, Wijdicks E (2002) Management of intracranial infectious aneurysms: a series of 16 cases. Neurosurgery 51:1145–1151 discussion 1151–1142PubMedCrossRef Phuong LK, Link M, Wijdicks E (2002) Management of intracranial infectious aneurysms: a series of 16 cases. Neurosurgery 51:1145–1151 discussion 1151–1142PubMedCrossRef
19.
go back to reference Piastra M, Chiaretti A, Tortorolo L (2000) Ruptured intracranial mycotic aneurysm presenting as cerebral haemorrhage in an infant: case report and review of the literature. Child’s Nerv Syst 16:190–193CrossRef Piastra M, Chiaretti A, Tortorolo L (2000) Ruptured intracranial mycotic aneurysm presenting as cerebral haemorrhage in an infant: case report and review of the literature. Child’s Nerv Syst 16:190–193CrossRef
20.
go back to reference Scotti G, Li MH, Righi C, Simionato F, Rocca A (1996) Endovascular treatment of bacterial intracranial aneurysms. Neuroradiology 38:186–189PubMedCrossRef Scotti G, Li MH, Righi C, Simionato F, Rocca A (1996) Endovascular treatment of bacterial intracranial aneurysms. Neuroradiology 38:186–189PubMedCrossRef
21.
go back to reference Sugg RM, Weir R, Vollmer DG, Cacayorin ED (2006) Cerebral mycotic aneurysms treated with a neuroform stent: technical case report. Neurosurgery 58:E381 discussion E381PubMedCrossRef Sugg RM, Weir R, Vollmer DG, Cacayorin ED (2006) Cerebral mycotic aneurysms treated with a neuroform stent: technical case report. Neurosurgery 58:E381 discussion E381PubMedCrossRef
22.
go back to reference Utoh J, Miyauchi Y, Goto H, Obayashi H, Hirata T (1995) Endovascular approach for an intracranial mycotic aneurysm associated with infective endocarditis. J Thorac Cardiovasc Surg 110:557–559PubMedCrossRef Utoh J, Miyauchi Y, Goto H, Obayashi H, Hirata T (1995) Endovascular approach for an intracranial mycotic aneurysm associated with infective endocarditis. J Thorac Cardiovasc Surg 110:557–559PubMedCrossRef
23.
go back to reference Watanabe A, Hirano K, Ishii R (1998) Cerebral mycotic aneurysm treated with endovascular occlusion–case report. Neurol Med Chir (Tokyo) 38:657–660CrossRef Watanabe A, Hirano K, Ishii R (1998) Cerebral mycotic aneurysm treated with endovascular occlusion–case report. Neurol Med Chir (Tokyo) 38:657–660CrossRef
Metadata
Title
Infectious intracranial aneurysms in the pediatric population: endovascular treatment with Onyx
Authors
Christopher S. Eddleman
Daniel Surdell
Arthur DiPatri Jr
Tadanori Tomita
Ali Shaibani
Publication date
01-08-2008
Publisher
Springer-Verlag
Published in
Child's Nervous System / Issue 8/2008
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-008-0614-8

Other articles of this Issue 8/2008

Child's Nervous System 8/2008 Go to the issue