Kim Ji Hwa, Suh Sang Hyun, Chung Joonho, Oh Yeo-Jin, Ahn Sung Jun, Lee Kyung-Yul
Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
J Stroke. 2016 Sep;18(3):321-327. doi: 10.5853/jos.2016.00164. Epub 2016 Aug 4.
The prevalence of unruptured cerebral aneurysms (UCAs) in ischemic stroke patients is not clearly defined. This study aimed to measure the prevalence and characteristics of UCAs in patients with acute ischemic stroke (AIS) and to compare our findings with those of the general population. In addition, we investigated the factors associated with cerebral aneurysms in AIS patients.
We retrospectively reviewed the brain magnetic resonance angiography images of 955 patients with AIS and 2,118 controls who had received a brain magnetic resonance angiography as part of a health check-up. We investigated the prevalence, size, location, and risk factors of the subjects in the context of UCAs.
UCAs were found in 74 patients with AIS (7.7%) and in 79 who received a health check-up (3.7%). The prevalence of UCAs was significantly higher in the AIS group than in the health check-up group (odds ratio 2.17, 95% confidence interval 1.56-3.01). The mean aneurysm diameter was larger in the AIS group than in the health check-up group (3.75 mm vs. 3.02 mm, =0.009). UCAs were primarily located in the internal carotid artery in both groups, and aneurysms in the middle cerebral artery were particularly common in the AIS group. According to multivariate analysis, hypertension alone was associated with an increased prevalence of UCAs in stroke patients.
This study identified a higher prevalence and larger size of UCAs in AIS patients than in the general population. Hypertension was an independent risk factor of UCA in AIS.
缺血性卒中患者中未破裂脑动脉瘤（UCA）的患病率尚无明确定义。本研究旨在测量急性缺血性卒中（AIS）患者中UCA的患病率及特征，并将我们的研究结果与普通人群的结果进行比较。此外，我们还调查了AIS患者中与脑动脉瘤相关的因素。
我们回顾性分析了955例AIS患者和2118例作为健康体检一部分接受脑磁共振血管造影的对照者的脑磁共振血管造影图像。我们在UCA的背景下调查了受试者的患病率、大小、位置和危险因素。
在74例AIS患者（7.7%）和79例接受健康体检者（3.7%）中发现了UCA。AIS组中UCA的患病率显著高于健康体检组（优势比2.17，95%置信区间1.56 - 3.01）。AIS组的动脉瘤平均直径大于健康体检组（3.75 mm对3.02 mm，P = 0.009）。两组中UCA主要位于颈内动脉，大脑中动脉的动脉瘤在AIS组中尤为常见。根据多变量分析，仅高血压与卒中患者中UCA患病率增加相关。
本研究发现AIS患者中UCA的患病率高于普通人群，且动脉瘤更大。高血压是AIS患者中UCA的独立危险因素。
