Predictors for Occurrence and Anatomical Distribution of Multiple Aneurysms in Patients with Aneurysmal Subarachnoid Hemorrhage.

Roethlisberger, Michel; Achermann, Rita; Bawarjan, Schatlo; Stienen, Martin N; Fung, Christian; Dalonzo, Donato; Maldaner, Nicolai; Ferrari, Andrea; Corniola, Marco V; Schöni, Daniel Stephan; Valsecchi, Daniele; Maduri, Rodolfo; Seule, Martin A; Burkhardt, Jan-Karl; Marbacher, Serge; Bijlenga, Philippe; Blackham, Kristine A; Bucher, Heiner C; Mariani, Luigi; Guzman, Raphael; ... (2018). Predictors for Occurrence and Anatomical Distribution of Multiple Aneurysms in Patients with Aneurysmal Subarachnoid Hemorrhage. World neurosurgery, 111, e199-e205. Elsevier 10.1016/j.wneu.2017.12.046

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BACKGROUND Literature on multiple intracranial aneurysms (MIA) in patients with aneurysmal subarachnoid hemorrhage (aSAH) largely focuses on risk factor analysis and consists essentially of retrospective cohort studies of limited sample size, or else studies in populations outside Europe and North America. OBJECTIVE The purpose of this cohort study was to determine the predictors for aneurysm multiplicity and to investigate the anatomical distribution of MIA in a representative Western cohort of aSAH patients. METHODS The Swiss Study of Subarachnoid Hemorrhage (SOS) database includes anonymized data from all tertiary neurovascular facilities in Switzerland. The dataset 2009-2014 was used to compare characteristics of aSAH patients with MIA and aSAH patients with a single intracranial aneurysm (SIA) by means of descriptive and multivariate regression analysis. RESULTS Out of 1689 unselected aSAH patients, 467 had MIA (prevalence: 27.6%). The location of the ruptured index aneurysm was correlated with the probability of finding bystander aneurysm(s) and predicted their likely anatomical distribution. Patients with a ruptured basilar artery (OR 2.08, 95%CI 1.28-3.37) or a ruptured middle cerebral artery (OR 1.86, 95%CI 1.36-2.55) aneurysm had the highest likelihood for MIA. Larger size of the index aneurysm (OR per 1mm 1.03, 95%CI 1.01-1.06) was also positively correlated with aneurysm multiplicity. Males compared to females were less likely to have MIA (OR 0.78, 95%CI 0.61-1.01). CONCLUSION In patients suffering from aSAH the location of the ruptured index aneurysm correlates with the probability of finding bystander aneurysm(s) and predicts the sites where bystander aneurysm(s) are the most likely found.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Fung, Christian and Schöni, Daniel Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1878-8750

Publisher:

Elsevier

Language:

English

Submitter:

Nicole Söll

Date Deposited:

18 Jan 2018 16:47

Last Modified:

28 Oct 2019 23:26

Publisher DOI:

10.1016/j.wneu.2017.12.046

PubMed ID:

29258940

Uncontrolled Keywords:

aneurysm aneurysm multiplicity subarachnoid hemorrhage

BORIS DOI:

10.7892/boris.108600

URI:

https://boris.unibe.ch/id/eprint/108600

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