Risk factors predicting a higher grade of subarachnoid haemorrhage in small ruptured intracranial aneurysm (&lt; 5 mm)

Tai, Junli; Liu, Jianxin; Lv, Jing; Kang, Huibin; Hou, Zhe; Yang, Jun; Zhang, Hongbing; Huang, Qi

doi:10.5603/pjnns.a2019.0029

Cited by 8 publications

(8 citation statements)

References 35 publications

(58 reference statements)

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“…The inflow angle of an intracranial aneurysm is a useful indicator for predicting rupture risk of intracranial aneurysm. 11) In our study, the number of patients with inflow angles less than 90 degrees was much greater than the number of patients with inflow angles more than 90 degrees in both the groups. The mean value of the inflow angle in the VSIA group was lower than that in the non-VSIA group.…”

Section: Discussioncontrasting

confidence: 53%

Characteristics of patients with ruptured very small intracranial aneurysm sized less than 3 mm

Park

Kim

Jung

et al. 2021

J Cerebrovasc Endovasc Neurosurg

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Objective: If the size of an intracranial aneurysm is below 3 mm, clinicians rarely treat them because of the low risk of rupture. But subarachnoid hemorrhage (SAH) due to the rupture of very small intracranial aneurysm (VSIA) (saccular aneurysm sized less than 3 mm) may lead to many critical neurological complications. So we analyzed the characteristics and differences between the ruptured VSIA group and the ruptured non-VSIA group. Methods: 421 saccular aneurysms from patients with SAH between January 2016 and December 2019 were included. Patient information including age, sex, and medical history and information about the aneurysm including location, size, aspect ratio, inflow angle, and height-width ratio were collected. And we compared the VSIA group with non-VSIA group about these characteristics Results: 12.1% (51/421) of the aneurysms were included in the VSIA group, while the non-VSIA group consisted of 87.9% of the aneurysms (370/421). The female predominance was significantly higher in the VSIA group than that in the non-VSIA group (p=0.011). No significant difference was observed in location, medical history, height-width ratio between the groups. The mean value of the inflow angle in the VSIA group was much lower than that in the non-VSIA group, but no statistically significant association between rupture risk and the inflow angle was observed. The average aspect ratio was significantly lower than that in the non-VSIA group. Conclusions: Ruptured VSIA group has higher percentage of females and lower aspect ratio than ruptured non-VSIA group. Further studies regarding the characteristics of ruptured and unruptured VSIA patients is required for assistance in clinical decision related to treatment of VSIA group before the aneurysmal sac rupture.

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Section: Discussioncontrasting

confidence: 53%

Characteristics of patients with ruptured very small intracranial aneurysm sized less than 3 mm

Park

Kim

Jung

et al. 2021

J Cerebrovasc Endovasc Neurosurg

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“…[ 19 ] In yet another study which was a retrospective clinical analysis of patients admitted to a Medical University hospital in China, it was concluded that alcohol use was significantly associated with higher severity (Hunt and Hess Score) of small intracranial aneurysm rupture. [ 20 ] Regular alcohol consumption is related to poor stroke outcome whereas higher frequency of alcohol intake is associated with hemorrhagic subtype of stroke. [ 18 ] Latter finding was not confirmed by the present work.…”

Section: Discussionmentioning

confidence: 99%

“…That higher frequency of alcohol intake results in higher severity and hemorrhagic stroke has been discussed earlier. [ 18 20 ]…”

Section: Discussionmentioning

confidence: 99%

Predictors of stroke subtype and severity in patients of a tertiary care hospital, Dehradun

Luthra¹,

Ohri²,

Kashyap³

et al. 2021

Indian J Community Med

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Context: Stroke caused 6.7 million deaths worldwide in 2013. In India, the cumulated incidence of stroke was 105–152/100,000 persons per year in last decade. Dearth of data on predictors of stroke subtype and severity in India lead to this study. Aims: (1) To categorize presenting stroke patients by subtype and severity. (2) To establish association of risk factors with above. (3) To predict subtype and severity by risk factors. Settings and Design: Hospital-based cross-sectional analytic, retrospective study. Subjects and Methods: A predesigned, pretested, semi-structured questionnaire with standard tool (National Institute of Health Stroke Scale Score), informed consent after prior approval of institutional ethics and research committees. Statistical Analysis Used: Percentages, proportions, Chi-square trends, linear regression, independent t -test, and analysis of variance (ANOVA). Results: Mean age of 102 patients was 62.1 (±12.8 years). Stroke subtype associated with socioeconomic status (χ 2 = 6.38775, P = 0.0115) and stroke severity (χ 2 = 18.98, P = 0) and stroke severity associated with stroke subtype (χ 2 = 9.79366, P = 0.0018). Stroke subtype could be predicted by stroke severity and stroke severity by subtype, sex, and dyslipidemia (regression models). Independent t -test revealed excessive alcohol intake was a significant predictor and one-way ANOVA revealed education was a significant predictor of severe stroke. Conclusions: Stroke subtype is significantly associated with higher socioeconomic status and severe stroke. Stroke severity is significantly associated with hemorrhagic stroke. Stroke subtype, sex, dyslipidemia, alcohol intake, and education may act as predictors of stroke severity.

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“…Тем не менее, по данным ряда авторов, большинство разорвавшихся церебральных аневризм имеют размеры менее 7 мм, и в практике встречаются случаи разрыва аневризм размером менее 3 мм [8][9][10][11][12][13][14][15][16][17]. Несмотря на это, ряд исследователей все же отрицает вероятность их разрыва, ссылаясь на то, что не известно, каким был истинный размер аневризмы до разрыва, и, возможно, она была больше, но после разрыва частично тромбировалась и сократилась [6].…”

Section: Introductionunclassified

Subarachnoid hemorrhage due to rupture of very small aneurysms of the anterior part of the circle of Willis

Shnyakin

Usatova

Trubkin

et al. 2022

Innovacionnaâ medicina Kubani

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Objective: To assess the frequency of ruptures of very small cerebral aneurysms, features of the perioperative period and outcomes, in comparison with the rupture of ordinarily sized aneurysms.Material and methods: A comparative analysis of the group of patients with ruptured cerebral miliary aneurysms (n = 18) and the group of patients with ruptured cerebral aneurysms of regular size (n = 308) was carried out. All patients underwent open surgery in the first 3 days after the rupture (osteoplastic craniotomy, microsurgical aneurysm clipping). We compared gender, age of patients, severity of the patient’s condition at the moment of admission, severity of subarachnoid hemorrhage, location of aneurysms, aspect ratio, duration of the operation, frequency of intraoperative ruptures, postoperative mortality.Results: It was found that miliary aneurysm rupture occurs in 5.5% of all patients with cerebral aneurysm rupture. The most common cases of rupture of very small aneurysms were in women (77.7%), with a mean age of 50.8 years. Aneurysms of the anterior communicating artery (66.6%) with a narrow neck (average aspect ratio – 2.1) were the most common. Patients with rupture of very small aneurysms were 7.9% more likely to be admitted in a state of subcompensation or decompensation (Hunt-Hess IV–V), they had massive subarachnoid hemorrhage (Fisher III) 19.6% more often than with ruptured aneurysms of regular size. On average, operations in cases of very small aneurysms lasted 30 minutes less than clipping of ordinary aneurysms, but were complicated by intraoperative rupture twice as often (38.8% and 16.5%, respectively). Postoperative mortality in the group of patients with ruptured miliary aneurysms was 5.7% higher than in patients with ruptured aneurysms of regular size.Conclusion: Rupture of cerebral miliary aneurysms is relatively rare. Women of 50–60 years old with very small aneurysms of the anterior communicating artery with a narrow neck constitute the main group of such patients. Massive subarachnoid hemorrhage and severe condition of patients on admission are more common with miliary aneurysms than with ordinarily sized aneurysms. The small size of the aneurysm and the work near the rupture determine the more frequent contact intraoperative rupture when the neck is exposed as compared to operations on larger aneurysms, which negatively affects the treatment outcomes in this group of patients.

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Risk factors predicting a higher grade of subarachnoid haemorrhage in small ruptured intracranial aneurysm (< 5 mm)

Cited by 8 publications

References 35 publications

Characteristics of patients with ruptured very small intracranial aneurysm sized less than 3 mm

Characteristics of patients with ruptured very small intracranial aneurysm sized less than 3 mm

Predictors of stroke subtype and severity in patients of a tertiary care hospital, Dehradun

Subarachnoid hemorrhage due to rupture of very small aneurysms of the anterior part of the circle of Willis

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