Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Aneurysmal Subarachnoid Hemorrhage in Third and Fourth Decades of Life

  • Kim, Su-Yong (Department of Neurosurgery, Gyeongsang National University School of Medicine & Gyeongsang Institute of Health Sciences) ;
  • Lee, Chul-Hee (Department of Neurosurgery, Gyeongsang National University School of Medicine & Gyeongsang Institute of Health Sciences) ;
  • Park, In Sung (Department of Neurosurgery, Gyeongsang National University School of Medicine & Gyeongsang Institute of Health Sciences) ;
  • Hwang, Jae Ha (Department of Neurosurgery, Gyeongsang National University School of Medicine & Gyeongsang Institute of Health Sciences) ;
  • Hwang, Soo Hyun (Department of Neurosurgery, Gyeongsang National University School of Medicine & Gyeongsang Institute of Health Sciences) ;
  • Han, Jong Woo (Department of Neurosurgery, Gyeongsang National University School of Medicine & Gyeongsang Institute of Health Sciences)
  • Received : 2012.03.15
  • Accepted : 2012.09.17
  • Published : 2012.09.28
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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.

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References

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