Multiple and mirror intracranial aneurysms: study of prevalence and associated risk factors.

Autor: Rosi Junior J; Division of Neurological Surgery, Hospital das Clinicas, University of São Paulo Medical School, Sao Paulo, Brazil., Gomes Dos Santos A; Division of Neurological Surgery, Hospital das Clinicas, University of São Paulo Medical School, Sao Paulo, Brazil., da Silva SA; Division of Neurological Surgery, Hospital das Clinicas, University of São Paulo Medical School, Sao Paulo, Brazil., Iglesio RF; Division of Neurological Surgery, Hospital das Clinicas, University of São Paulo Medical School, Sao Paulo, Brazil., Caldas JGMP; Division of Neurological Surgery, Hospital das Clinicas, University of São Paulo Medical School, Sao Paulo, Brazil., Rabelo NN; Division of Neurological Surgery, Hospital das Clinicas, University of São Paulo Medical School, Sao Paulo, Brazil., Teixeira MJ; Division of Neurological Surgery, Hospital das Clinicas, University of São Paulo Medical School, Sao Paulo, Brazil., Preul MC; Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, AZ, USA., Spetzler RF; Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, AZ, USA., Figueiredo EG; Division of Neurological Surgery, Hospital das Clinicas, University of São Paulo Medical School, Sao Paulo, Brazil.
Jazyk: angličtina
Zdroj: British journal of neurosurgery [Br J Neurosurg] 2021 Dec; Vol. 35 (6), pp. 780-784. Date of Electronic Publication: 2020 Nov 09.
DOI: 10.1080/02688697.2020.1817849
Abstrakt: Objective: Multiple intracranial aneurysms (MIA) account for 30% of all intracranial aneurysms, while mirror aneurysms, a subgroup of MIA, are present in 5% of all patients with cerebral aneurysms. We investigated the risk factors associated with the presence of multiple and mirror intracranial aneurysms.
Methods: 1404 patients, 314 males (22.4%) and 1090 female (77.6%) were enrolled for this study. Diagnosis was performed with a digital subtraction angiography (DSA). Multiplicity was defined as the presence of two or more aneurysms and mirror aneurysms as one pair of aneurysms involving bilateral corresponding arteries. Patients were followed-up from September 2009 till August 2018. Individuals' characteristics such as sex, age, smoking, hypertension and use of contraceptives were evaluated.
Results: Five hundred and twelve patients (36.4%) were diagnosed with MIA, approximately 4%/year. We observed 203 pairs of mirror aneurysms, accounting for 406 aneurysms (13% of the population). There was an increased frequency of females with multiple ( p < 0.001, OR = 1.883, 95% CI = 1.386-2.560 ) and mirror aneurysms ( p < 0.001, OR = 2.828, 95% CI = 1.725-4. 636). Smoking was associated with multiplicity ( p< 0.001, OR = 1.458, 95% CI = 1.160-1.833 ), as well as advanced age ( p < 0.001, OR = 1.938, 95% CI = 1.438-2.611 ), but there was no significant relation with presence of mirror aneurysms. We observed higher frequency of baby aneurysms (<3mm) in the group of patients with MIA, while giant aneurysms (>25 mm) were most found in patients with only one aneurysm ( p < 0.001 ). No differences between patients who used contraceptives against patients who did not use were found ( p = 0.600 ).
Conclusions: Gender and smoking, known risk factors to the development of a single intracranial aneurysm, are proportionally increased in patients with MIA. Hypertension and oral contraceptives were not associated with multiplicity.
Databáze: MEDLINE
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