Natural history of unruptured intracranial aneurysms: probability of and risk factors for aneurysm rupture

Background: Relatively high rates of complications occur after operation for unruptured intracranial aneurysms. Published data on endovascular treatment suggest lower rates of complications. We measured the impact of treatment of unruptured aneurysms by clipping or coiling on functional health, quality of life, and the level of anxiety and depression. Methods: In three centres, we prospectively collected data on patients with an unruptured aneurysm who were treated by clipping or coiling. Treatment assignment was left to the discretion of the treating physicians. Before, 3 and 12 months after treatment, we used standardised questionnaires to assess functional health (Rankin Scale score), quality of life (SF-36, EuroQol), and the level of anxiety and depression (Hospital Anxiety and Depression Scale). Results: Nineteen patients were treated by coiling and 32 by clipping. In the surgical group, 4 patients (12%) had a permanent complication; 36 of all 37 aneurysms (97%) were successfully clipped. Three months after operation, quality of life was worse than before operation; 12 months after operation, it had improved but had not completely returned to baseline levels. Scores for depression were higher than in the general population. In the endovascular group, no complications with permanent deficits occurred; 16 of 19 aneurysms (84%) were occluded by more than 90%. One patient died from rupture of the previously coiled aneurysm. In the others, quality of life after 3 months and after 1 year was similar to that before treatment. Conclusions: In the short term, operation of patients with an unruptured aneurysm has a considerable impact on functional health and quality of life. After 1 year, recovery occurs but it is incomplete. Coil embolisation does not affect functional health and quality of life.

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“…This risk was confirmed in a further study with a median period of follow-up of 20 years [2]. The case fatality after rupture is high, i.e.…”

Section: Introductionsupporting

confidence: 54%

Quality of Life after Treatment of Unruptured Intracranial Aneurysms by Neurosurgical Clipping or by Embolisation with Coils

et al. 2003

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“…Several studies have shown previously that essential hypertension is an important risk factor for aneurysmal SAH [9,10,11], and the present results are in agreement with these studies. There is substantial evidence to support the view that essential hypertension is closely related to chronic but not acute C. pneumoniae infection [7].…”

Section: Discussionsupporting

confidence: 83%

“…Recently, however, attention has been drawn to a possible link between C. pneumoniae and the pathogenesis of cerebral aneurysms causing subarachnoid hemorrhage (SAH). For example, C. pneumoniae is associated with essential hypertension [7, 8], which has been shown to be an important risk factor for aneurysmal SAH [9,10,11]. Kunze et al [12] have reported that SAH may occur within 4 weeks of infection of the upper respiratory tract.…”

Section: Introductionmentioning

confidence: 99%

<i>Chlamydia pneumoniae</i> Infection as a Risk Factor for Subarachnoid Hemorrhage

Yanagawa

Ouchi²,

Kunitsugu³

et al. 2005

Cerebrovasc Dis

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Many risk factors for subarachnoid hemorrhage (SAH), such as hypertension and recent infection, have already been established. Chlamydia pneumoniae is a common respiratory pathogen that has been implicated as a potential risk factor for hypertension and atherosclerotic diseases. The purpose of the case-control study presented here was to examine the causative relationship between C. pneumoniae infection and SAH. Serum C. pneumoniae IgG and IgA antibodies were measured using an enzyme-linked immunosorbent assay in 52 patients with SAH and in 104 healthy age-matched control subjects. Multivariate analysis revealed a significant association between SAH and both a strong seropositivity for IgG and/or IgA antibodies against C. pneumoniae (odds ratio, OR, 3.62; 95% confidence intervals, CI, 1.06–12.39; p = 0.040), which indicates the presence of acute C. pneumoniae infection, and hypertension (OR, 2.91; 95% CI, 1.42–5.96; p = 0.0035). These results provide evidence that infection with C. pneumoniae may be a risk factor for SAH from a ruptured intracranial aneurysm.

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“…К первым относят: генетические факторы [6][7][8]; ряд наследственных заболеваний (см. далее) [9][10][11][12][13][14][15][16][17][18]; возраст и пол [1, 2, [19][20][21][22][23][24][25][26][27][28][29]. Моди-фицируемыми факторами являются различные за-болевания сердечно-сосудистой системы (в первую очередь артериальная гипертония и атеросклероз), ряд факторов, влияющих на общее состояние здоро-вья (курение, алкоголь), а также длительный прием лекарств и других веществ с симпатомиметическим действием [20,28,[30][31][32][33][34].…”

Section: этиология и патогенезunclassified

“…Аневризмы чаще выявляются у женщин независимо от возрастной группы [1,2,[19][20][21][22][23][24][25][26][27][28][29].…”

Section: пол и возрастunclassified

Clinical guidelines for treatment of unruptured asymptomatic brain aneurysms

Krylov¹,

Eliava²,

Yakovlev³

et al. 2016

Vopr. neirokhir.

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Natural history of unruptured intracranial aneurysms: probability of and risk factors for aneurysm rupture

Cited by 624 publications

References 35 publications

Quality of Life after Treatment of Unruptured Intracranial Aneurysms by Neurosurgical Clipping or by Embolisation with Coils

Quality of Life after Treatment of Unruptured Intracranial Aneurysms by Neurosurgical Clipping or by Embolisation with Coils

<i>Chlamydia pneumoniae</i> Infection as a Risk Factor for Subarachnoid Hemorrhage

Clinical guidelines for treatment of unruptured asymptomatic brain aneurysms

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