J Korean Neurosurg Soc.  2012 Sep;52(3):167-171.

Aneurysmal Subarachnoid Hemorrhage in Third and Fourth Decades of Life

• Kim SY
• Lee CH
• Park IS
• Hwang JH
• Hwang SH
• Han JW

Abstract

OBJECTIVE
The aim of this study was to compare clinical characteristics of ruptured aneurysms in young adults, of the third and fourth decades of life, and to compare several clinical characteristics affecting the outcome of patients.
METHODS
We retrospectively investigated 1459 patients who underwent surgery and endovascular treatment for ruptured cerebral aneurysms from June 1992 to December 2010 and compared clinical characteristics. We also reviewed pre-existing medical conditions and perioperative complications.
RESULTS
Among 1459 patients, there were 21 patients (1.44%) in the third decade and 104 patients (7.13%) in the fourth decade of life. Within two age groups, 88 (70.4%) were male and 37 (29.6%) were female, a ratio of 2.37 : 1. In both groups, we observed the anterior cerebral artery (ACA) aneurysm with the most frequency (p=0.028). In general, favorable outcome was achieved in both age groups (90.5% and 81.7%, respectively). An initial univariate analysis showed Hunt-Hess grade, Fisher grade, location of aneurysm, and rebleeding significantly associated with outcome after aneurysm rupture. Further, multivariate analysis demonstrated that only Hunt-Hess grade (grade 4-5) was a risk factor for the outcome (odds ratio=9.730, 95% confidence interval 2.069-45.756, p=0.004).
CONCLUSION
The incidence of subarachnoid hemorrhage (SAH) was higher in the male population of the third and fourth decades of life. Aneurysms on the ACA were most frequently occurred in both age groups and the outcome of aneurysmal SAH among the third and fourth decades was favorable. Multivariate analysis revealed that high Hunt-Hess grade was a risk factor for patient's outcome.

Keyword

Aneurysm; Subarachnoid hemorrhage; Young adult

MeSH Terms

Aneurysm
Aneurysm, Ruptured
Anterior Cerebral Artery
Female
Humans
Incidence
Intracranial Aneurysm
Male
Multivariate Analysis
Retrospective Studies
Risk Factors
Rupture
Subarachnoid Hemorrhage
Young Adult

Figure

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  Fig. 1 Bar graph showing the age and sex distributions of 1459 patients who were surgically and endovascularly treated for aneurysmal subarachnoid hemorrhage.

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