gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Intracranial aneurysms in children and young adults: Report of 14 cases

Intrakranielle Aneurysmen bei Kindern und jungen Erwachsenen: Bericht über 14 Fälle

Meeting Abstract

  • corresponding author P. Kunkel - Klinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf
  • T. Martens - Klinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf
  • O. Heese - Klinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf
  • M. Westphal - Klinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf
  • J. Regelsberger - Klinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 09.119

The electronic version of this article is the complete one and can be found online at:

Published: May 8, 2006

© 2006 Kunkel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Subarachnoid hemorrhage (SAH) due to ruptured cerebral aneurysms in childhood is a rare diagnosis and believed to differ from those in adults regarding their clinical appearance and outcome suggesting aneurysms in childhood to be a distinct entity. We retrospectively analyzed our data of 1810 aneurysm patients (1983-2005) to find possible particularities of the clinical course in 14 young patients (age 1-20).

Methods: 14 children and young adults with a mean age of 13.8 years suffered from aneurismal subarachnoid hemorrhage (12 cases) or had unruptured but symptomatic aneurysms (2 cases). Hunt&Hess scores obtained at time of admission revealed two patients of grade 0, four patients of grade I, two of grade II, four of grade III and two of grade V. Overall there were five female and nine male patients. Anterior circulation aneurysms were diagnosed in eleven patients whereas three patients had posterior circulation aneurysms. Seven large (10-25mm) aneurysms and seven smaller than 10 mm were found. Surgical clipping of the aneurysms was performed in 13 patients, in one case clipping could not be completed because of excessive brain swelling.

Results: Ten patients showed no significant disability or any symptoms at all according to Modified Rankin Scale (MRS) 0 or 1. Two patients suffered of persisting nerve palsies (MRS=2), a 6 year old boy admitted with SAH Hunt&Hess grade V died due to the initial fatal clinical condition followed by severe brain edema and secondary pulmonary complications, a 15 month old girl also graded Hunt&Hess V died of excessive brain edema the second day after surgery. Statistical analysis found significant correlations between age of the patient, aneurysm size, extent of SAH and clinical outcome (p<0.001).

Conclusions: Despite the possibility that younger age may be a significant biological factor, in this retrospectively analyzed series of 14 young aneurysm patients who all underwent surgical treatment, no difference in clinical course or outcome was found compared to the results obtained in adult populations. High grade Hunt&Hess SAH patients with giant aneurysms were found to have a poor prognosis, excellent outcome was achieved in Hunt&Hess grade I-III patients.