Epidemiological analysis of 1404 patients with intracranial aneurysm followed in a single Brazilian institution

Abstract

Background: We sought to evaluate the epidemiology of intracranial aneurysms in relation to location, gender, age, presence of multiple aneurysms, and comorbidities in the Brazilian population. Methods: We performed a prospective analysis of a cohort of 1404 patients diagnosed with intracranial aneurysm admitted to the Hospital das Clinicas of the University of Sao Paulo, a referral hospital for the treatment of cerebrovascular diseases in Brazil. Patients admitted between September 2009 and September 2018 with radiological diagnosis of intracranial aneurysm were included in the study. Results: A total of 2251 aneurysms were diagnosed. Females accounted for 1090 aneurysms (77.6%) and the mean age at diagnosis was 54.9 years (ranging 15–88). The most common location was middle cerebral artery (MCA) with 593 aneurysms (26.3%) followed by anterior cerebral artery (ACA) with 417 aneurysms (18.5%) and internal carotid artery in the posterior communicating segment with 405 aneurysms (18.0%). Males had higher rates of ACA aneurysms (29.7%) while females had higher rates of MCA aneurysms (26.1%). Sorting by size, 492 aneurysms were <5 mm (21.8%), 1524 measured 5–10 mm (67.7%), 119 size 11–24 mm (5.3%), and 116 were >24 mm (5.2%). The occurrence of multiple aneurysms was associated with female gender (P < 0.001) and smoking (P < 0.001), but not with hypertension (P = 0.121). Conclusion: In this population, the occurrence of intracranial aneurysm is related to several factors, including gender, age, smoking, and hypertension. Our study brought to light important characteristics of a large number of Brazilian patients regarding epidemiology, location, size, and multiplicity of intracranial aneurysms.

Evaluation of the Results of Therapeutic Management of Patients Treated Endovascularly for Cerebral Aneurysm

“…Compared to other studies, this is a consistent result, which indicates that women have an increased risk of developing an aneurysm of the brain, including the unruptured one, although the reasons for this are unknown [23,24]. The average age of the examined people was 53, which is consistent with other studies that show the average age of 50 years for the global population with diagnosed intracranial aneurysm [25].…”

Epidemiological characteristics and causes of death after Aneurysmal Subarachnoid Hemorrhage – SAH

“…Published series on cerebral aneurysm warn that age is an important data to be considered, as they are rare in children and the incidence increases according to age in both sexes. 4,8 Thus, the same behavior is true in relation to aneurysmal subarachnoid hemorrhage, until at least the eighth decade. 13 This seems to support the theory of hormonal decline in menopause, contributing to the greater occurrence of this ictus among women as age increases.…”

“…The large epidemiological studies that address cerebrovascular diseases are not very specific, leading to the imprecision of the occurrence of this type of hemorrhage in the country. [3][4][5] The genesis of cerebral aneurysms is multicausal and can be divided into two groups: modifiable and nonmodifiable factors. 6 Because of its character, it is not possible to act directly on some of the predictors, for example, genetic factors.…”

“…7 The most recent epidemiological studies have shown that, contrary to the traditional concept, the incidence of SAH increases with age, with a predominance in women; however, the greatest risk of death falls on men. 4,8 As for the causes of death resulting from aneurysmal rupture, findings in the literature reveal that many of them are related to the patient's own condition, associated with advanced age, comorbidities and lifestyle. 9 Others to a low clinical degree in the initial assessment, complications during hospitalization and treatment of this ictus.…”

Risk factors and treatment approach for subarachnoid hemorrhage in a patient with nine intracranial aneurysms

“…Overall case fatality is usually around half of the cases, although there are some novel studies that present in-hospital mortality much lower [1]. In more than one-third of the patients with subarachnoid hemorrhage (SAH), multiple intracranial aneurysms are reviled [2] which usually makes difficult their treatment.…”