Unruptured intracranial aneurysms in children with sickle cell disease

Analysis of 18 aneurysms in 5 patients

Surbhi Saini, Barbara Speller-Brown, Emily Wyse, Emily R. Meier, Jessica Carpenter, Ross M. Fasano, Monica S. Pearl

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

BACKGROUND: Intracranial aneurysms (IAs) are rare in the general pediatric population and account for <2% of all cerebral aneurysms. Only 7 children with sickle hemoglobinopathy and IAs have been reported, the majority of which were discovered after rupture. OBJECTIVE: To report the prevalence of unruptured IAs in a selected population of children with sickle cell disease (SCD) and to describe the aneurysm morphology, hematologic characteristics, and management in this patient population. METHODS: A retrospective review of the electronic database for all children with SCD who underwent brain magnetic resonance imaging or angiography from January 2002 to August 2013 at a single institution was performed. Records were reviewed for IA, age, sex, sickle cell genotype, neurological symptoms, hematologic indexes, transcranial Doppler findings, and management. RESULTS: Five of 179 children (2.8%) with SCD imaged by brain magnetic resonance imaging or angiography were diagnosed with IAs. None presented with subarachnoid hemorrhage. Four patients (80%) had HbSS disease, and 1 patient had hemoglobin sickle cell HbSC disease. A total of 18 aneurysms were detected; the majority of patients had multiple aneurysms (80%) and bilateral involvement (60%). CONCLUSION: Children with SCD are at risk for developing multiple intracranial aneurysms, and a high index of suspicion must be maintained during the interpretation of routine magnetic resonance imaging or angiography of the brain.

Original languageEnglish (US)
Pages (from-to)531-539
Number of pages9
JournalNeurosurgery
Volume76
Issue number5
DOIs
StatePublished - Jan 1 2015

Fingerprint

Sickle Cell Anemia
Intracranial Aneurysm
Aneurysm
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Brain
Population
Hemoglobinopathies
Subarachnoid Hemorrhage
Rupture
Hemoglobins
Genotype
Databases
Pediatrics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Saini, S., Speller-Brown, B., Wyse, E., Meier, E. R., Carpenter, J., Fasano, R. M., & Pearl, M. S. (2015). Unruptured intracranial aneurysms in children with sickle cell disease: Analysis of 18 aneurysms in 5 patients. Neurosurgery, 76(5), 531-539. https://doi.org/10.1227/NEU.0000000000000670
Saini, Surbhi ; Speller-Brown, Barbara ; Wyse, Emily ; Meier, Emily R. ; Carpenter, Jessica ; Fasano, Ross M. ; Pearl, Monica S. / Unruptured intracranial aneurysms in children with sickle cell disease : Analysis of 18 aneurysms in 5 patients. In: Neurosurgery. 2015 ; Vol. 76, No. 5. pp. 531-539.
@article{23036c5c17ce4418be99f176e364afe3,
title = "Unruptured intracranial aneurysms in children with sickle cell disease: Analysis of 18 aneurysms in 5 patients",
abstract = "BACKGROUND: Intracranial aneurysms (IAs) are rare in the general pediatric population and account for <2{\%} of all cerebral aneurysms. Only 7 children with sickle hemoglobinopathy and IAs have been reported, the majority of which were discovered after rupture. OBJECTIVE: To report the prevalence of unruptured IAs in a selected population of children with sickle cell disease (SCD) and to describe the aneurysm morphology, hematologic characteristics, and management in this patient population. METHODS: A retrospective review of the electronic database for all children with SCD who underwent brain magnetic resonance imaging or angiography from January 2002 to August 2013 at a single institution was performed. Records were reviewed for IA, age, sex, sickle cell genotype, neurological symptoms, hematologic indexes, transcranial Doppler findings, and management. RESULTS: Five of 179 children (2.8{\%}) with SCD imaged by brain magnetic resonance imaging or angiography were diagnosed with IAs. None presented with subarachnoid hemorrhage. Four patients (80{\%}) had HbSS disease, and 1 patient had hemoglobin sickle cell HbSC disease. A total of 18 aneurysms were detected; the majority of patients had multiple aneurysms (80{\%}) and bilateral involvement (60{\%}). CONCLUSION: Children with SCD are at risk for developing multiple intracranial aneurysms, and a high index of suspicion must be maintained during the interpretation of routine magnetic resonance imaging or angiography of the brain.",
author = "Surbhi Saini and Barbara Speller-Brown and Emily Wyse and Meier, {Emily R.} and Jessica Carpenter and Fasano, {Ross M.} and Pearl, {Monica S.}",
year = "2015",
month = "1",
day = "1",
doi = "10.1227/NEU.0000000000000670",
language = "English (US)",
volume = "76",
pages = "531--539",
journal = "Neurosurgery",
issn = "0148-396X",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

Saini, S, Speller-Brown, B, Wyse, E, Meier, ER, Carpenter, J, Fasano, RM & Pearl, MS 2015, 'Unruptured intracranial aneurysms in children with sickle cell disease: Analysis of 18 aneurysms in 5 patients', Neurosurgery, vol. 76, no. 5, pp. 531-539. https://doi.org/10.1227/NEU.0000000000000670

Unruptured intracranial aneurysms in children with sickle cell disease : Analysis of 18 aneurysms in 5 patients. / Saini, Surbhi; Speller-Brown, Barbara; Wyse, Emily; Meier, Emily R.; Carpenter, Jessica; Fasano, Ross M.; Pearl, Monica S.

In: Neurosurgery, Vol. 76, No. 5, 01.01.2015, p. 531-539.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Unruptured intracranial aneurysms in children with sickle cell disease

T2 - Analysis of 18 aneurysms in 5 patients

AU - Saini, Surbhi

AU - Speller-Brown, Barbara

AU - Wyse, Emily

AU - Meier, Emily R.

AU - Carpenter, Jessica

AU - Fasano, Ross M.

AU - Pearl, Monica S.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - BACKGROUND: Intracranial aneurysms (IAs) are rare in the general pediatric population and account for <2% of all cerebral aneurysms. Only 7 children with sickle hemoglobinopathy and IAs have been reported, the majority of which were discovered after rupture. OBJECTIVE: To report the prevalence of unruptured IAs in a selected population of children with sickle cell disease (SCD) and to describe the aneurysm morphology, hematologic characteristics, and management in this patient population. METHODS: A retrospective review of the electronic database for all children with SCD who underwent brain magnetic resonance imaging or angiography from January 2002 to August 2013 at a single institution was performed. Records were reviewed for IA, age, sex, sickle cell genotype, neurological symptoms, hematologic indexes, transcranial Doppler findings, and management. RESULTS: Five of 179 children (2.8%) with SCD imaged by brain magnetic resonance imaging or angiography were diagnosed with IAs. None presented with subarachnoid hemorrhage. Four patients (80%) had HbSS disease, and 1 patient had hemoglobin sickle cell HbSC disease. A total of 18 aneurysms were detected; the majority of patients had multiple aneurysms (80%) and bilateral involvement (60%). CONCLUSION: Children with SCD are at risk for developing multiple intracranial aneurysms, and a high index of suspicion must be maintained during the interpretation of routine magnetic resonance imaging or angiography of the brain.

AB - BACKGROUND: Intracranial aneurysms (IAs) are rare in the general pediatric population and account for <2% of all cerebral aneurysms. Only 7 children with sickle hemoglobinopathy and IAs have been reported, the majority of which were discovered after rupture. OBJECTIVE: To report the prevalence of unruptured IAs in a selected population of children with sickle cell disease (SCD) and to describe the aneurysm morphology, hematologic characteristics, and management in this patient population. METHODS: A retrospective review of the electronic database for all children with SCD who underwent brain magnetic resonance imaging or angiography from January 2002 to August 2013 at a single institution was performed. Records were reviewed for IA, age, sex, sickle cell genotype, neurological symptoms, hematologic indexes, transcranial Doppler findings, and management. RESULTS: Five of 179 children (2.8%) with SCD imaged by brain magnetic resonance imaging or angiography were diagnosed with IAs. None presented with subarachnoid hemorrhage. Four patients (80%) had HbSS disease, and 1 patient had hemoglobin sickle cell HbSC disease. A total of 18 aneurysms were detected; the majority of patients had multiple aneurysms (80%) and bilateral involvement (60%). CONCLUSION: Children with SCD are at risk for developing multiple intracranial aneurysms, and a high index of suspicion must be maintained during the interpretation of routine magnetic resonance imaging or angiography of the brain.

UR - http://www.scopus.com/inward/record.url?scp=84928110746&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84928110746&partnerID=8YFLogxK

U2 - 10.1227/NEU.0000000000000670

DO - 10.1227/NEU.0000000000000670

M3 - Article

VL - 76

SP - 531

EP - 539

JO - Neurosurgery

JF - Neurosurgery

SN - 0148-396X

IS - 5

ER -