XXXX in adolescents.

@entity1 @entity510 @entity425 @entity439 @entity432 @entity892 @entity715 @entity2849 @entity1319 @entity438
PURPOSE: @entity438 are extremely uncommon in adolescents. This study was undertaken to assess the clinical and radiological characteristics and clarify the choice of therapeutic strategies of @entity438 in adolescents with age range from 15 to 18 years. METHODS: From our dedicated aneurysmal databank between October 1985 and July 2008, we reviewed 16 consecutive adolescents who had 20 @entity438 . RESULTS: Ten @entity1 and six @entity1 (male/female ratio = 1.67:1; mean age 16.78      1.18 years) were included in the present study. @entity438 in adolescents constituted 0.91% of all @entity438 . It was found that 25% of the lesions were in the posterior circulation, while 75% of the lesions were in the anterior circulation, and 25% developed on the middle cerebral artery (MCA). Half of the @entity1 presented with @entity510 and others mainly presented with mass effect such as @entity425 , @entity892 , and @entity1319 . Eight cases underwent endovascular treatment: including GDC therapy in five @entity1 , parental @entity432 in two @entity1 , and cover stent implantation in one @entity1 with @entity2849 of the cavernous segment of the left internal carotid artery. Four @entity1 received microsurgical therapy: aneurismal neck clipping for two @entity1 and extracranial-intracranial (EC-IC) bypass and trapping of complex @entity439 in MCA for the other two @entity1 . Four @entity1 did not receive microsurgical or endovascular therapy, including a @entity1 whose @entity439 spontaneously thrombosed preoperatively and a @entity1 who died before operation because of rerupture of @entity439 . Two @entity1 did not undergo therapy owing to the high operative risk. All of the @entity1 who received therapy had favorable outcome (GOS 4 or 5) at discharge and at follow-up. CONCLUSIONS: @entity438 in adolescents differ from those in adults in many ways including the following: male predominance; high incidence of large or giant, traumatic, dissecting, and fusiform @entity439 ; high incidence of @entity439 in the posterior circulation; high incidence of spontaneous @entity715 ; better Hunt-Hess grade at presentation; and better therapeutic outcome. Both microsurgical approaches and endovascular treatment were effective. For some giant, @entity438 , parent @entity432 or EC-IC bypass is the best treatment choice.
