e935

Authors

• Hiroki Sato, Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Japan.Follow
• Tomoya Kamide, Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Japan. Electronic address: kamide@med.kanazawa-u.ac.jp.
• Yuichiro Kikkawa, Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Japan.
• Tatsuki Kimura, Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Japan.
• Seiji Kuribara, Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Japan.
• Taro Yanagawa, Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Japan.
• Kaima Suzuki, Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Japan.
• Toshiki Ikeda, Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Japan.
• Hiroki Kurita, Department of Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Japan.

Document Type

Article

Abstract

OBJECTIVE: It is difficult to correctly identify the ruptured aneurysm in patients with multiple intracranial aneurysms. Here, we investigated the clinical characteristics of ruptured intracranial aneurysms in such patients. METHODS: We retrospectively analyzed 361 patients who underwent microsurgical clipping of ruptured intracranial aneurysms at our institution from 2012 to 2018. Patients' age, sex, Fisher group, World Federation of Neurosurgical Societies grade, size (neck width, depth, maximum diameter), location, and shape of intracranial aneurysm, and hemorrhage pattern on admission were reviewed. RESULTS: In total, 266 patients (74%) had single intracranial aneurysms and 95 (26%) had multiple intracranial aneurysms. Eighty-nine of the 95 multiple intracranial aneurysms (94%) had irregular shape (P < 0.01). The median aspect ratios of ruptured and unruptured intracranial aneurysms were 2.2 ± 1.1 and 1.0 ± 0.4, respectively (P < 0.01). Twelve of 95 patients (13%) had ruptured intracranial aneurysms that were smaller than unruptured intracranial aneurysms. Among the 12 patients, the aspect ratios of ruptured intracranial aneurysms were greater than those of unruptured intracranial aneurysms (P < 0.01). Regarding morphologic characteristics, aspect ratio, maximum size, and irregular shape could be the useful predictive factors, but the greatest aspect ratio among patients with multiple aneurysms was the most predictive of an intracranial aneurysm rupture, after adjustment for aneurysmal size (adjusted odds ratio 217.82; 95% confidence interval 56.41-841.08). CONCLUSIONS: The results of this study indicate that the aspect ratio is the most predictive factor of a ruptured intracranial aneurysm in patients with multiple intracranial aneurysms.

Keywords

Aspect ratio, Multiple, Ruptured aneurysms

Medical Subject Headings

Adult; Aged; Aged, 80 and over; Aneurysm, Ruptured (diagnostic imaging, surgery); Angiography, Digital Subtraction; Cerebral Angiography; Female; Humans; Imaging, Three-Dimensional; Intracranial Aneurysm (diagnostic imaging, surgery); Magnetic Resonance Angiography; Male; Microsurgery; Middle Aged; Neurosurgical Procedures; Retrospective Studies; Rupture, Spontaneous; Tomography, X-Ray Computed

Publication Date

5-1-2021

Publication Title

World neurosurgery

E-ISSN

1878-8769

Volume

149

Last Page

e941

PubMed ID

33508494

Digital Object Identifier (DOI)

10.1016/j.wneu.2021.01.072

Recommended Citation

Sato, Hiroki; Kamide, Tomoya; Kikkawa, Yuichiro; Kimura, Tatsuki; Kuribara, Seiji; Yanagawa, Taro; Suzuki, Kaima; Ikeda, Toshiki; and Kurita, Hiroki, "e935" (2021). Translational Neuroscience. 2595.
https://scholar.barrowneuro.org/neurobiology/2595