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Clinical characteristics and individualized treatment of intracranial aneurysms in young adults: a single-center experience

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Abstract

This study aimed to investigate the clinical characteristics of intracranial aneurysms in young adults and summarize our treatment experiences. We performed a retrospective review of young patients (15–24 years old) with intracranial aneurysms examined in the Fifth Ward of the Neurosurgery Department of Tianjin Huanhu Hospital between January 2015 and November 2022. Data was reviewed for age, sex, presentation, type and size, treatment modalities, location, postoperative complications, and clinical and imaging outcomes. Among the 23 patients, there were 11 males and 12 females (1:1.09). Their presentations included headache, neurological deficits, aneurysmal subarachnoid hemorrhage, incidental or asymptomatic aneurysm, and traumatic subarachnoid hemorrhage. Twenty-five cases of intracranial aneurysms in 25 patients were identified. The aneurysms were saccular (32%, 8/25), dissecting (52%, 13/25), and fusiform (16%, 4/25) in shape. Treatment modalities included direct clipping, embolization, bypass, trapping, resection, coarctation of internal carotid artery (ICA), and endovascular vessel sacrifice. Of the 25 aneurysms, 16 (64%, 16/25) aneurysms were located in anterior circulation, and 9 (36%, 9/25) were located in the posterior circulation, while multiple aneurysms were identified in two patients. A preoperative magnetic resonance perfusion (MRP) examination was performed in 15 patients with unruptured complex aneurysms, of whom 13/15 (86.67%) showed hypoperfusion. Eighteen (78.26%, 18/23) patients had no postoperative complications, temporary complications occurred in 4 (17.39%, 4/23) patients, and 1 patient died postoperatively. The intracranial aneurysms in young adults (15 ~ 24 years old) are rare. The posterior circulation is more commonly involved than adults, giant and huge aneurysms are frequent, and fusiform and dissecting pathologic features are common. Headache is the most common clinical manifestation. Individualized treatment should be performed, and bypass is an effective treatment for young patients with intracranial aneurysms.

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References

  1. Meyer FB, Sundt TM Jr, Fode NC, Morgan MK, Forbes GS, Mellinger JF (1989) Cerebral aneurysms in childhood and adolescence. J Neurosurg 70:420–425

    Article  PubMed  CAS  Google Scholar 

  2. Liang JT, Huo LR, Bao YH, Zhang HQ, Wang ZY, Ling F (2011) Intracranial aneurysms in adolescents. Childs Nerv Syst 27:1101–1107

    Article  PubMed  Google Scholar 

  3. Liang J, Bao Y, Zhang H, Wrede KH, Zhi X, Li M, Ling F (2009) The clinical features and treatment of pediatric intracranial aneurysm. Childs Nerv Syst 25:317–324

    Article  PubMed  Google Scholar 

  4. Proust F, Toussaint P, Garniéri J, Hannequin D, Legars D, Houtteville JP, Fréger P (2001) Pediatric cerebral aneurysms. J Neurosurg 94:733–739

    Article  PubMed  CAS  Google Scholar 

  5. Nam SM, Jang D, Wang KC, Kim SK, Phi JH, Lee JY, Cho WS, Kim JE, Kang HS (2019) Characteristics and treatment outcome of intracranial aneurysms in children and adolescents. J Korean Neurosurg Soc 62:551–560

    Article  PubMed  PubMed Central  Google Scholar 

  6. Gross BA, Smith ER, Scott RM, Orbach DB (2015) Intracranial aneurysms in the youngest patients: characteristics and treatment challenges. Pediatr Neurosurg 50:18–25

    Article  PubMed  Google Scholar 

  7. Kakarla UK, Beres EJ, Ponce FA, Chang SW, Deshmukh VR, Bambakidis NC, Zabramski JM, Spetzler RF (2010) Microsurgical treatment of pediatric intracranial aneurysms: long-term angiographic and clinical outcomes. Neurosurgery 67:237–249 (discussion 250)

    Article  PubMed  Google Scholar 

  8. Garrido E, Metayer T, Borha A, Langlois O, Curey S, Papagiannaki C, Di Palma C, Emery E, Derrey S, Gaberel T, Gilard V (2021) Intracranial aneurysms in pediatric population: a two-center audit. Childs Nerv Syst 37:2567–2575

    Article  PubMed  Google Scholar 

  9. Huang J, McGirt MJ, Gailloud P, Tamargo RJ (2005) Intracranial aneurysms in the pediatric population: case series and literature review. Surg Neurol 63:424–432 (discussion 432-433)

    Article  PubMed  Google Scholar 

  10. Koroknay-Pál P, Lehto H, Niemelä M, Kivisaari R, Hernesniemi J (2012) Long-term outcome of 114 children with cerebral aneurysms. J Neurosurg Pediatr 9:636–645

    Article  PubMed  Google Scholar 

  11. Lu J, Li M, Zhao Y, Zhao Y, Chen X, Zhao J (2022) Paediatric intracranial aneurysms: long-term angiographic and clinical outcomes in a contemporary series. Front Neurol 13:684093. https://doi.org/10.3389/fneur.2022.684093

    Article  PubMed  PubMed Central  Google Scholar 

  12. Pritz MB (2011) Cerebral aneurysm classification based on angioarchitecture. J Stroke Cerebrovasc Dis 20:162–167

    Article  PubMed  Google Scholar 

  13. Wiebers DO, Whisnant JP, Huston J 3rd, Meissner I, Brown RD Jr, Piepgras DG, Forbes GS, Thielen K, Nichols D, O’Fallon WM, Peacock J, Jaeger L, Kassell NF, Kongable-Beckman GL, Torner JC (2003) Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet 362:103–110

    Article  PubMed  Google Scholar 

  14. Lasjaunias P, Wuppalapati S, Alvarez H, Rodesch G, Ozanne A (2005) Intracranial aneurysms in children aged under 15 years: review of 59 consecutive children with 75 aneurysms. Childs Nerv Syst 21:437–450

    Article  PubMed  Google Scholar 

  15. Gemmete JJ, Toma AK, Davagnanam I, Robertson F, Brew S (2013) Pediatric cerebral aneurysms. Neuroimaging Clin N Am 23:771–779

    Article  PubMed  Google Scholar 

  16. Mehrotra A, Nair AP, Das KK, Srivastava A, Sahu RN, Kumar R (2012) Clinical and radiological profiles and outcomes in pediatric patients with intracranial aneurysms. J Neurosurg Pediatr 10:340–346

    Article  PubMed  Google Scholar 

  17. Ghali M, Srinivasan VM, Cherian J, Wagner KM, Chen SR, Johnson J, Lam SK, Kan P (2018) Multimodal treatment of intracranial aneurysms in children: clinical case series and review of the literature. World Neurosurg 111:e294–e307

    Article  PubMed  Google Scholar 

  18. Jee TK, Nam TM, Yeon JY, Kim KH, Jeon P, Kim JS, Hong SC (2020) Intracranial aneurysms in young adult patients: surgical and endovascular treatment outcomes. World Neurosurg 136:e214–e222

    Article  PubMed  Google Scholar 

  19. Sanai N, Quinones-Hinojosa A, Gupta NM, Perry V, Sun PP, Wilson CB, Lawton MT (2006) Pediatric intracranial aneurysms: durability of treatment following microsurgical and endovascular management. J Neurosurg 104:82–89

    PubMed  Google Scholar 

  20. Ganesh Kumar N, Ladner TR, Kahn IS, Zuckerman SL, Baker CB, Skaletsky M, Cushing D, Sanborn MR, Mocco J, Ecker RD (2017) Parent vessel occlusion for treatment of cerebral aneurysms: is there still an indication? A series of 17 patients. J Neurol Sci 372:250–255

    Article  PubMed  Google Scholar 

  21. Vachhani JA, Nickele CM, Elijovich L, Klimo P, Arthur AS (2016) Flow diversion for treatment of growing A2 aneurysm in a child: case report and review of flow diversion for intracranial aneurysms in pediatric patients. World Neurosurg 96:607.e13-607.e17. https://doi.org/10.1016/j.wneu.2016.09.078

    Article  PubMed  Google Scholar 

  22. Lasjaunias PL, Campi A, Rodesch G, Alvarez H, Kanaan I, Taylor W (1997) Aneurysmal disease in children. Review of 20 cases with intracranial arterial localisations. Interv Neuroradiol 3:215–229

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

We express our sincere appreciation to Mrs. Zhirui Liu for the editorial assistance.

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Authors and Affiliations

  1. Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China

    Wenqiang Guo, Xingdong Wang, Jingang Bao, Zhiqiang Wang & Xiaoguang Tong

  2. Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin, China

    Hu Wang, Yanguo Shang, Minggang Shi, Xuan Wang & Xiaoguang Tong

  3. Department of Neurosurgery, Tianjin Central Hospital for Neurosurgery and Neurology, Tianjin, China

    Hu Wang, Yanguo Shang, Minggang Shi, Xuan Wang & Xiaoguang Tong

  4. Laboratory of Microneurosurgery, Tianjin Neurosurgical Institute, Tianjin, China

    Xiaoguang Tong

  5. Tianjin Key Laboratory of Cerebral Vascular and Neural Degenerative Diseases, Tianjin, China

    Xiaoguang Tong

Authors
  1. Wenqiang Guo
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  2. Hu Wang
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  3. Yanguo Shang
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  4. Minggang Shi
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  5. Xuan Wang
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  6. Xingdong Wang
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  8. Zhiqiang Wang
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  9. Xiaoguang Tong
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Contributions

Xiaoguang Tong raised and designed this subject. Wenqiang Guo collected and extracted data, and drafted the article. Hu Wang, Yanguo Shang, Xingdong Wang, Jingang Bao, and Zhiqiang Wang collected and extracted data. Minggang Shi and Xuan Wang commented the content. Xiaoguang Tong revised the manuscript and approved the version.

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Correspondence to Xiaoguang Tong.

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This study was approved by the Ethics Committee of the Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University.

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The authors declare no competing interests.

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Guo, W., Wang, H., Shang, Y. et al. Clinical characteristics and individualized treatment of intracranial aneurysms in young adults: a single-center experience. Neurosurg Rev 46, 122 (2023). https://doi.org/10.1007/s10143-023-02025-0

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  • DOI: https://doi.org/10.1007/s10143-023-02025-0

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