青年颅内动脉瘤流行病学及影像学特点

研究背景目前针对青年颅内动脉瘤患者的临床流行病学调查资料甚少,尤其国内尚无相关文献报道,本文旨在探讨16～29岁青年颅内动脉瘤患者的发病及影像学特点。方法共对2008年1月-2012年10月住院治疗的2119例颅内动脉瘤患者的临床资料进行回顾分析。结果其中年龄16～29岁的青年颅内动脉瘤患者41例,约占同期总病例数的1.93%(41/2119)。影像学检查共发现42个动脉瘤,前循环35个、后循环7个,以前交通动脉动脉瘤所占比例最高,约为30.95%(13/42);大脑中动脉和大脑前动脉远端动脉瘤各占14.29%(6/42);后交通动脉动脉瘤所占比例较低,仅为4.76%(2/42)。位于Willis环分叉部及近侧大动脉上的动脉瘤共34个占80.95%、动脉周围支上者8个占19.05%,其中直径≤5mm者45.24%(19/42)、6～10mm者30.95%(13/42)、11～24mm者7.14%(3/42)、≥25mm者16.67%(7/42)。结论青年(16～29岁)颅内动脉瘤男性患者发病率显著高于女性,但随着年龄的增长,女性动脉瘤发病率呈上升趋势。前交通动脉是青年颅内动脉瘤的好发部位,以巨大型、后循环动脉瘤及大脑前动脉远端动脉瘤所占比例较高。青年(16～29岁)颅内动脉瘤的流行病学及影像学特征与儿童颅内动脉瘤相近,与成人存在明显差异。

Epidemiological and imaging features of intracranial aneurysms in young adults

Background Nowadays, the epidemiological report and study about the intracranial aneurysms in young adults are very rare, especially in China. This paper aims to investigate the epidemiologieal and imaging features of intraeranial aneurysms in young adults with the age of 16-29 years old. Methods Clinical data of 2119 patients with intraeranial aneurysms admitted from January 2010 to October 2012 were retrospectively analyzed. Results Intracranial aneurysms in young adults （16-29 years old） accounted for 1.93% of all intraeranial aneurysms （41/2119） treated in the same period, and the gender ratio （male ： female） was 2.15 ： 1. A total of 42 intracranial aneurysms were found in 41 patients, including 35 located in the anterior circulation and 7 in the posterior circulation, of which 13 aneurysms （30.95%） in the anterior communicating artery, 6 aneurysms （14.29%） each in the middle cerebral artery and the distal of anterior cerebral artery, and 2 aneurysms （4.76%） in the posterior communicating artery. There were almost 34 aneurysms （80.95%） located in bifurcation of Willis circle and proximal aorta and 8 aneurysms （19.05%） in the branches of artery. The diameter of aneurysms were ~〈 5 mm in 19 aneurysms （45.24%）, 6-10 mm in 13 （30.95%）, 11-24 mm in 3 （7.14%） and ≥25 mm in 7 （16.67%）. Conclusion Young men are much more susceptible to intraeranial aneurysms than young women, hut the incidence in women increases as they grow old. The anterior communicating artery is the predilection site of intracranial aneurysms in young adults （16-29 years old）, and the occurence of giant aneurysms and the aneurysms in the posterior circulation and the distal of anterior cerebral artery is common. The epidemiological and imaging features and gender ratio of intracranial aneurysms in young adults （16-29 years old） are similar to those in children and adolesents, but much different from adult patients.