• Parthiban Balasundaram, Leve Joseph Devarajan Sebastian, Nishchint Jain, Anuj Prabhakar, Ajay Garg, and Shailesh Gaikwad.
• Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, New Delhi, India.
• World Neurosurg. 2019 May 1; 125: e273-e281.

BackgroundArterial pseudoaneurysms of the neck are rarely reported in the pediatric population and no dedicated large series are available. Trauma and infection are the most common causes for these aneurysms, with congenital and collagen vascular disorders being the less common causes. These lesions can be life threatening, especially when they present with bleeding or airway compromise.MethodsWe searched our radiology information system for all cases of pediatric neck aneurysm presented between June 2015 and May 2018. These cases were analyzed for clinicoepidemiologic variables, clinical presentation, imaging findings, management, and follow-up.ResultsSix children were included in the study (male/female ratio, 5:1), with a mean age of 7.8 years (range, 2.5-15 years). Four presented acutely with either bleeding or rapidly enlarging neck swelling, whereas 2 presented with slowly increasing pulsatile swelling. One had a traumatic cause, 2 had infections, and 1 had infective cervical lymphadenitis complicated by iatrogenic injury whereas no definite causative mechanisms could be accounted for in 2 patients. Two of the children were managed by trapping of the aneurysm and 2 only by proximal parent vessel occlusion. The other 2 children were treated with stent graft deployment across the aneurysm neck to reconstruct the parent vessel. All the patients were doing well during the follow-up period (mean, 14.8 months).ConclusionsEndovascular means of treatment for pediatric neck aneurysms is relatively simple and safe. Although parent vessel sacrifice is the gold-standard management, vessel-preserving strategies can be tried in select cases with favorable anatomy.Copyright © 2019 Elsevier Inc. All rights reserved.

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