Sun N, Yang XY, Zhao Y, Zhang QJ, Ma X, Wei ZN, Li MQ. Treatment of pediatric intracranial dissecting aneurysm with clipping and angioplasty, and next-generation sequencing analysis: A case report and literature review . World J Clin Cases 2021; 9(5): 1103-1110 [PMID: 33644173 DOI: 10.12998/wjcc.v9.i5.1103]
Corresponding Author of This Article
Ning Sun, MD, Surgeon, Department of Neurosurgery, Tianjin Children's Hospital/Tianjin University Children's Hospital, No. 238 Longyan Road, Beichen District, Tianjin 300134, China. sunning64tj@yahoo.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 16, 2021; 9(5): 1103-1110 Published online Feb 16, 2021. doi: 10.12998/wjcc.v9.i5.1103
Treatment of pediatric intracranial dissecting aneurysm with clipping and angioplasty, and next-generation sequencing analysis: A case report and literature review
Ning Sun, Xin-Yu Yang, Yan Zhao, Qing-Jiang Zhang, Xiao Ma, Zhong-Nan Wei, Meng-Qi Li
Ning Sun, Qing-Jiang Zhang, Xiao Ma, Zhong-Nan Wei, Department of Neurosurgery, Tianjin Children's Hospital/Tianjin University Children's Hospital, Tianjin 300134, China
Xin-Yu Yang, Yan Zhao, Meng-Qi Li, Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin 300052, China
Author contributions: Sun N, Yang XY, and Zhao Y drafted the manuscript; Zhang QJ and Ma X prepared the figures; Wei ZN and Li MQ prepared the clinical and imaging data; Sun N finalized the manuscript; Yang XY checked and reviewed the article; All authors read and approved the final draft.
Supported byNational Natural Science Foundation of China, No. 81571144
Informed consent statement: Informed written consent was obtained from the parents of the patient for publication of this report and accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016)
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ning Sun, MD, Surgeon, Department of Neurosurgery, Tianjin Children's Hospital/Tianjin University Children's Hospital, No. 238 Longyan Road, Beichen District, Tianjin 300134, China. sunning64tj@yahoo.com
Received: August 12, 2020 Peer-review started: August 12, 2020 First decision: December 3, 2020 Revised: December 11, 2020 Accepted: December 23, 2020 Article in press: December 23, 2020 Published online: February 16, 2021 Processing time: 171 Days and 0.8 Hours
Abstract
BACKGROUND
Large intracranial dissecting aneurysm (IDA) in the anterior cerebral circulation is rare in children. There has been no consensus on the diagnosis and treatment for IDA in children.
CASE SUMMARY
We report a 3-year-old boy with a large ruptured IDA in the right middle cerebral artery (16 mm × 14 mm). The IDA was successfully managed with clipping and angioplasty. Next-generation sequencing of the blood sample followed by bioinformatics analysis suggested that the rs78977446 variant of the ADAMTS13 gene is a risk for pediatric IDA. Three years after surgery, the boy was develop-mentally normal.
CONCLUSION
Clipping and angioplasty are effective treatments for ruptured IDA in the anterior cerebral circulation. ADAMTS13 rs78977446 is a risk factor for pediatric IDA.
Core Tip: The index case was a 3-year-old boy with a large ruptured intracranial dissecting aneurysm in the right middle cerebral artery (16 mm × 14 mm). He was successfully treated by clipping and angioplasty. Whole-genome high-throughput sequencing identified the rs78977446 variant of the ADAMTS13 gene. Bioinformatics analysis using the American College of Medical Genetics guidelines and literature search suggested that this variant is a risk factor for pediatric intracranial dissecting aneurysm.
