Intracranial Aneurysms in the 3rd and 4th Decades in Comparison with Those in the 8th and 9th Decades

ABSTRACT

OBJECTIVE: This study is performed to compare older with younger groups about clinical characteristics and overall outcome of treatments for the intracranial aneurysms. METHODS: We retrospectively investigated 633 patients with cerebral aneurysms who were admitted to our institute from January 2000 to May 2004. The authors divided the patients of cerebral aneurysm into two groups, one the third, fourth decades and the other eighth, ninth decades, analyzed clinical characteristics and overall outcome of treatments. RESULTS: There were 57 patients (9.0%) under 39years old and 58 patients (9.2%) over 70. The female to male sex ratio was 0.51 in the younger group(YG) and 7.31 in the older group(OG), showing a female predominance with increasing age. In the YG, aneurysms were found in anterior communicating artery(A-com) (44.8%), middle cerebral artery (31.0%). In the OG, aneurysm of posterior communicating artery (30.1%) was most common followed by that of A-com (26.9%). More smokers and alcoholics were found in the YG. Older age was related to poor Hunt-Hess grade, Fisher's grade on admission, high incidence of unruptured aneurysms, and endovascular surgery. There was a higher prevalence of hypertension, intraventricular hematoma, hydrocephalus, and rebleeding in the preoperative state in the OG and postoperative complications including hydrocephalus, subdural fluid collection, and systemic complications. Overall outcome was poorer with advancing age (p=0.01). CONCLUSION: The patients with aneurysms in the YG have distinct characteristics compared to those in the OG. Because of a good clinical grade on admission, a thin subarachnoid clot, and low incidence of perioperative complications, the overall outcomes of the young patients were better than those of the old patients.