Division of Neurological Surgery, Hospital das Clinicas, University of São Paulo Medical School, Sao Paulo, Brazil.
Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, AZ, USA.
Br J Neurosurg. 2021 Dec;35(6):780-784. doi: 10.1080/02688697.2020.1817849. Epub 2020 Nov 9.
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.
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.
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 () and mirror aneurysms (636). Smoking was associated with multiplicity (), as well as advanced age (), 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 (). No differences between patients who used contraceptives against patients who did not use were found ().
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.
多发颅内动脉瘤（MIA）占所有颅内动脉瘤的 30%，而镜像动脉瘤是 MIA 的一个亚组，占所有脑动脉瘤患者的 5%。我们研究了与多发性和镜像颅内动脉瘤存在相关的危险因素。
本研究纳入了 1404 名患者，其中男性 314 名（22.4%），女性 1090 名（77.6%）。诊断采用数字减影血管造影（DSA）。多发性定义为存在两个或多个动脉瘤，镜像动脉瘤定义为一对涉及双侧相应动脉的动脉瘤。患者从 2009 年 9 月随访至 2018 年 8 月。评估了个体特征，如性别、年龄、吸烟、高血压和使用避孕药。
512 名患者（36.4%）被诊断为 MIA，约为 4%/年。我们观察到 203 对镜像动脉瘤，占 406 个动脉瘤（人群的 13%）。多发性和镜像动脉瘤患者中女性的发生率较高（分别为 636 和 636）。吸烟与多发性（）和年龄较大（）有关，但与镜像动脉瘤的存在无关。我们观察到 MIA 患者中多发微小动脉瘤（<3mm）的发生率较高，而只有一个动脉瘤的患者中巨型动脉瘤（>25mm）最为常见（）。使用避孕药的患者与未使用避孕药的患者之间没有差异（）。
性别和吸烟是单个颅内动脉瘤发生的已知危险因素，在 MIA 患者中比例增加。高血压和口服避孕药与多发性无关。
