title: Aneurysmal subarachnoid hemorrhage in third and fourth decades of life.
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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neurosurgery, Gyeongsang National University School of Medicine & Gyeongsang Institute of Health Sciences, Jinju, Korea.
authors.forename: Su-Yong
authors.initials: SY
authors.lastname: Kim
authors.forename: Chul-Hee
authors.initials: CH
authors.lastname: Lee
authors.forename: In Sung
authors.initials: IS
authors.lastname: Park
authors.forename: Jae Ha
authors.initials: JH
authors.lastname: Hwang
authors.forename: Soo Hyun
authors.initials: SH
authors.lastname: Hwang
authors.forename: Jong Woo
authors.initials: JW
authors.lastname: Han
keywords: Aneurysm; Subarachnoid hemorrhage; Young adult