Nam Sun Mo, Jang Donghwan, Wang Kyu-Chang, Kim Seung-Ki, Phi Ji Hoon, Lee Ji Yeoun, Cho Won-Sang, Kim Jeong Eun, Kang Hyun-Seung
Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
J Korean Neurosurg Soc. 2019 Sep;62(5):551-560. doi: 10.3340/jkns.2019.0140. Epub 2019 Aug 30.
Intracranial aneurysms are not common in young age patients. We sought to find the characteristics of the intracranial aneurysms in patients under 20 years of age.
We reviewed 23 consecutive patients ≤20 years of age treated for their intracranial aneurysms during the period from 1995 to 2017. From medical records and imaging studies, we gathered data on age, sex, presentation, associated medical condition, location and characteristics of aneurysms, treatment and clinical outcomes.
The patients' ages ranged from 13 months to 20 years (median, 14 years). There were 16 males and seven females (male to female ratio, 2.3 : 1) with 31 aneurysms. Clinical presentations included sudden severe headache in 61%, followed by altered mentality in 17% and seizure in 17%. More than one-fourth patients had specific medical conditions related to the development of the cerebral aneurysms. The majority of aneurysms occurred in the anterior circulation (71%), and were saccular (71%). There were each three patients with false aneurysms (13%) and giant aneurysms (13%), and only one patient with multiple aneurysms (4%). We treated 22 patients : 21 aneurysms with the endovascular methods, three with open surgery, and one with combined treatment. Good functional outcome could be achieved in 86% during the follow-up period.
In this series, the young-age patients with intracranial aneurysms were characterized by male predominance, related specific medical conditions, low incidence of multiple aneurysms, high incidence of giant aneurysms and good functional outcome after treatment.
颅内动脉瘤在年轻患者中并不常见。我们试图找出20岁以下患者颅内动脉瘤的特征。
我们回顾了1995年至2017年期间连续治疗的23例年龄≤20岁的颅内动脉瘤患者。从病历和影像学研究中，我们收集了有关年龄、性别、临床表现、相关疾病、动脉瘤的位置和特征、治疗方法及临床结果的数据。
患者年龄从13个月至20岁不等（中位数为14岁）。16例男性，7例女性（男女比例为2.3∶1），共31个动脉瘤。临床表现包括61%的患者出现突发剧烈头痛，其次是17%的患者意识改变和17%的患者癫痫发作。超过四分之一的患者患有与脑动脉瘤发生相关的特定疾病。大多数动脉瘤发生在前循环（71%），呈囊状（71%）。假性动脉瘤（13%）和巨大动脉瘤（13%）各有3例患者，只有1例患者患有多发动脉瘤（4%）。我们治疗了22例患者：21个动脉瘤采用血管内治疗方法，3个采用开放手术，1个采用联合治疗。随访期间86%的患者可获得良好的功能预后。
在本系列研究中，年轻的颅内动脉瘤患者具有男性居多、存在相关特定疾病、多发动脉瘤发生率低、巨大动脉瘤发生率高及治疗后功能预后良好的特点。
