Aneurysmal Subarachnoid Hemorrhage in Young Adult Patients: Single Center Reports

Objective The mechanisms underlying the formation and rupture of intracranial aneurysms in young adults remain a matter of debate. This study aimed to evaluate the clinical characteristics of young adult patients with aneurysmal subarachnoid hemorrhage (SAH) treated with endovascular or clipping techniques at a single center. Methods Seventeen young adult patients (age, 18-40 years; 7 men and 10 women; mean age, 35.7 years) with aneurysmal SAH were treated at our hospital using an endovascular or clip ligation approach between February 2018 and March 2023. The clinical outcomes, complications, and patient characteristics were evaluated. The mean follow-up duration was 13 months (range, 0-44 months). Results The male-to-female ratio was 0.7 (7 vs. 10 patients), and the most common location of aneurysm was the internal carotid artery (7 patients, 41.2%). Two patients (11.8%) presented with a history of hypertension, and six (35.3%) with smoking. The overall favorable outcome rate was 64.7% (Glasgow Outcome Scale [GOS] 4 and 5), while unfavorable outcomes occurred in 35.3% of patients (GOS 1, 2, and 3). None of the patients rebounded after clipping or endovascular treatment. Two (14.3%) patients treated with coil embolization (14 patients) showed an interval change in the residual neck (recanalization). Conclusion Our results suggest that young adults with ruptured intracranial aneurysms exhibit different characteristics. However, well-controlled investigations using larger prospective studies are warranted to further clarify the clinical characteristics of these patients, including the mechanisms of aneurysm formation and rupture. Key words: Endovascular procedures; Clip; Intracranial aneurysm; Young adult