Dinger Thiemo F, Darkwah Oppong Marvin, Park Chikadibia, Said Maryam, Chihi Mehdi, Rauschenbach Laurèl, Gembruch Oliver, Deuschl Cornelius, Wrede Karsten H, Lenz Veronika, Kleinschnitz Christoph, Forsting Michael, Sure Ulrich, Jabbarli Ramazan
1Department of Neurosurgery and Spine Surgery, University Hospital, University of Duisburg-Essen, Essen, Germany.
2Institute for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital, University of Duisburg-Essen, Essen, Germany.
J Neurosurg. 2022 Feb 4;137(4):1056-1063. doi: 10.3171/2021.11.JNS212325. Print 2022 Oct 1.
The prevalence of multiple intracranial aneurysms (MIAs) has increased over the last decades. Because MIAs have been identified as an independent risk factor for formation, growth, and rupture of intracranial aneurysms (IAs), a more profound understanding of the underlying pathophysiology of MIAs is needed. Therefore, the authors' extensive institutional aneurysm database was analyzed to elucidate differences between patients with a single IA (SIA) and those with MIAs.
A total of 2446 patients seen with or for IAs at the University Hospital of Essen, Essen, Germany, from January 2003 to June 2016 were included in this retrospective cohort study and were separated into MIA and SIA subgroups. Patient data were screened for sociodemographic and radiographic parameters, preexisting medical conditions, and results of blood examinations. These parameters were analyzed for their correlations with MIAs and absolute number of IAs.
MIAs were identified in 853 (34.9%) patients. In multivariable analysis, MIAs were independently associated with female sex (p = 0.001), arterial hypertension (p = 0.023), tobacco abuse (p = 0.009), AB blood group (p = 0.010), and increased admission values for C-reactive protein (p = 0.006), mean corpuscular volume (p = 0.009), and total serum protein (p = 0.034), but not with diagnostic modality (3D vs 2D digital subtraction angiography, p = 0.912). Absolute number of IAs was independently associated with female sex (p < 0.001), arterial hypertension (p = 0.014), familial predisposition to IA (p = 0.015), tobacco consumption (p = 0.025), increased mean corpuscular volume (p = 0.002), and high platelet count (p = 0.007).
In this sizable consecutive series of patients with IAs, the authors confirmed the impact of common IA risk factors on the genesis of MIAs. In addition, specific hemorheological and hemocytological features may also contribute to the development of MIAs.
在过去几十年中，多发性颅内动脉瘤（MIA）的患病率有所上升。由于MIA已被确定为颅内动脉瘤（IA）形成、生长和破裂的独立危险因素，因此需要更深入地了解MIA的潜在病理生理学。因此，对作者所在机构广泛的动脉瘤数据库进行分析，以阐明单发IA（SIA）患者与MIA患者之间的差异。
本回顾性队列研究纳入了2003年1月至2016年6月期间在德国埃森大学医院因IA就诊或接受治疗的2446例患者，并将其分为MIA和SIA亚组。对患者数据进行筛选，以获取社会人口统计学和影像学参数、既往病史以及血液检查结果。分析这些参数与MIA和IA绝对数量的相关性。
853例（34.9%）患者被诊断为MIA。在多变量分析中，MIA与女性（p = 0.001）、动脉高血压（p = 0.023）、吸烟（p = 0.009）、AB血型（p = 0.010）以及C反应蛋白（p = 0.006）、平均红细胞体积（p = 0.009）和总血清蛋白（p = 0.034）的入院值升高独立相关，但与诊断方式（3D与2D数字减影血管造影，p = 0.912）无关。IA的绝对数量与女性（p < 0.001）、动脉高血压（p = 0.014）、IA家族易感性（p = 0.015）、吸烟（p = 0.025）、平均红细胞体积升高（p = 0.002）和高血小板计数（p = 0.007）独立相关。
在这一规模较大的连续性IA患者系列中，作者证实了常见IA危险因素对MIA发生的影响。此外，特定的血液流变学和血细胞学特征也可能有助于MIA的发生发展。
