Clinical outcome and health-related quality of life in Pediatric intracranial aneurysm, a single-center experience

To investigate the association of treatment approaches on the clinical outcomes and health-related quality of life (HRQL) of Pediatric intracranial aneurysms (PIAs) at our institution. A retrospective analysis of 37 children with PIAs treated from 2015 to 2022. Clinical outcomes were evaluated using the modified Rankin Score (mRS) and Lovett scale. Additionally, the HRQL was assessed using the PedsQL 4.0 questionnaire. Thirty-seven children were admitted with 41 aneurysms. Of these, 15 patients underwent surgical treatment, 16 received endovascular therapy, and 6 were managed conservatively. After an average follow-up period of 2.8 years, the median mRS was 0 for endovascular therapy against 1.5 for surgical treatment (p=0.443). Similarly, limb muscle strength was higher in the endovascular group (5 vs. 4, p=0.433). PedsQL 4.0 assessments demonstrated excellent reliability (α=0.907), with no significant difference between the endovascular and surgical groups in overall HRQL (p=0.390, 95% CI: -6.892 to 16.978). However, the endovascular group showed a trend toward improved quality of life, including physical, emotional, and social functioning. Active treatments yield favorable outcomes for children with PIAs. Our study is the first to demonstrate that endovascular approach may offer a beneficial long-term improvement in HRQL for children with PIAs.