Spontaneous Intracranial Aneurysm in Young Adult Patients: Retrospective Review of 157 Patients

ABSTRACT

OBJECTIVE: This study is undertaken to review clinical characteristics of spontaneous intracranial aneurysms in young adult patients. METHODS: The authors reviewed medical records and radiological findings in patients, aged 16 to 35 with spontaneous intracranial aneurysm(s) who underwent transcranial or endovascular treatment in our hospital from 1989 to 2002. RESULTS: The number of cases was 157 and the ratio of male to female was 95:62. The majority(88.5%) of patients presented with subarachnoid hemorrhage and underlying medical diseases were found only in 12.1%. Acccording to Hunt-Hess grade, 145 patients(92.4%) showed good clinical grade on admission. Aneurysms were located most commomly at the anterior communicating artery(35.7%). Patients with multiple aneurysms were 11.5% and giant aneurysms were found in 4.5%. We performed transcranial surgery in 95.5% and endovascular treatment in 4.5%. 144 patients(91.7%) showed good outcome at discharge and 8 patients died of rebleeding in two cases, brain swelling in two cases, postoperative infarction after parent artery occlusion in two cases, vasospasm in one case, and acute myocardial infarction in one case. CONCLUSION: Because of good neurological status on admission, low incidence of intraventricular hemorrhage and hydrocephaus, low incidence of underlying medical disease, and low incidence of symptomatic vasospasm, the overall outcomes of the young adult patients are better than those of the old patients.