Risk Factors for Higher Volume of Hemorrhage in Ruptured Anterior Circulation Intracranial Aneurysms

Abstract

Purpose: To explore the influencing factors of volume hemorrhage in ruptured anterior circulation aneurysms, so as to identify the characteristics of anterior circulation aneurysms with high volume of hemorrhage, and to provide advice for clinical diagnosis and treatment for those aneurysms. Methods: We retrospectively reviewed 437 cases of ruptured anterior intracranial aneurysms in our center between the years 2012 and 2017. According to the inclusion criteria, a total of 100 qualified patients were screened out. We collected demographic characteristics, environmental exposure, and admission status of enrolled patients. In addition, morphological parameters and location of aneurysms were also included. The semiautomatic threshold method was used to measure the volume of hemorrhage. According to the results, the patients were divided into the group with high blood volume and low blood volume. Univariate and multivariate logistic regression analyses were used to discover the related factors affecting the bleeding volume. Results: In univariable analysis, pulse pressure ( P = 0.014) showed a significant difference at the P < 0.05 test level. In terms of aneurysm morphology, the irregular shape ( P < 0.001), calcification ( P = 0.001), and flow angle ( P = 0.006) showed significant statistical differences between the two groups at the P < 0.01 level ( P < 0.01). Multivariate logistic regression analysis showed that irregular shape (OR = 5.370 P = 0.002 < 0.05), large flow angle (OR = 1.033 P = 0.016 < 0.05), and calcification (OR = 5.460 P = 0.003 < 0.05) were risk factors for volume of hemorrhage in ruptured anterior circulation aneurysms. The influence of hypertension history was at critical state (OR = 2.877 P = 0.051 > 005). Conclusions: According to our analysis results, intracranial anterior circulation aneurysms with irregular shapes, calcifications, and large flow angle are more dangerous. Aneurysms with these characteristics often have a large amount of hemorrhage, requiring timely treatment in clinical practice.