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Clinical analysis of young adult patients with ruptured intracranial aneurysms: a single-center study of 113 consecutive patients

대한뇌혈관외과학회지 2020년 22권 3호 p.127 ~ 133
이원재, 김미경, 임용철,
소속 상세정보
이원재 ( Lee Won-Jae ) - Ajou University School of Medicine Ajou University Hospital Department of Neurosurgery
김미경 ( Kim Mi-Kyung ) - Ajou University School of Medicine Ajou University Hospital Department of Neurosurgery
임용철 ( Lim Yong-Cheol ) - Ajou University School of Medicine Ajou University Hospital Department of Neurosurgery

Abstract


Objective: Intracranial aneurysm most frequently occurs in old aged patients; however, aneurysmal subarachnoid hemorrhage (SAH) has been occasionally reported in young adults. This study aimed to compare patients with intracranial aneurysms younger than 40 years with those ≥40 years and investigates the characteristics of their ruptured aneurysm.

Methods: We retrospectively collected the data of 389 patients (103 patients aged 20 to 39 years; 286 patients aged above 40 years) who were treated for ruptured cerebral aneurysms between January 2008 and December 2018 at our institution.

Results: The young adult patients were more often men and were smokers as compared to controls (63.1% vs. 39.2%, 40.5% vs. 36.0%, respectively). The young adult patients showed a tendency for lower Hunt and Hess grade, modified Fisher grade, less postoperative morbidity, and better clinical outcome. Aneurysm ruptures occurred most frequently in the anterior cerebral artery in both groups, but aneurysms ruptures in the internal carotid artery and posterior circulation was infrequent among young adult patients. The aneurysms in young adult patients were more often elongated or irregularly shaped (82.5% vs. 64.0%, respectively) and were significantly smaller (5.9 mm) than that in controls (6.8 mm).

Conclusions: Ruptured aneurysms of young adult patients have unique characteristics with regard to its preponderance in male smoker, elongated or irregular shape and relatively smaller size.

키워드

Adult; Aneurysm; Ruptured intracranial aneurysm; Subarachnoid hemorrhage

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