Department of Neurosurgery and Spine Surgery, and Center for Translational Neuroscience and Behavioral Science (C-TNBS), University Hospital of Essen, University of Duisburg-Essen, Essen, North Rhine-Westphalia, Germany.
Department of Neurosurgery, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Brain Behav. 2024 Nov;14(11):e70161. doi: 10.1002/brb3.70161.
The size of unruptured intracranial aneurysms (UIA) remains the most crucial risk factor for treatment decisions. On the other side, there is a non-negligible portion of small ruptured IA and large stable UIA. This study aimed to identify the patients' characteristics related to IA size in the context of IA rupture status.
A total of 2152 patients, with 1002 being hospitalized for an acute aneurysmal subarachnoid hemorrhage (SAH), were included from our institutional IA database. Different demographic and clinical characteristics of patients and IA were collected. IA size was the study endpoint, assessed as continuous variable in univariate and multivariable linear regression analysis, separately for ruptured (R) IA and UIA.
The mean IA size was 8.3 and 7.3 mm in the UIA and RIA subpopulations, respectively. Higher age (p = 0.003) and baseline blood urea level (p < 0.001) were independently associated with increasing UIA size. In contrast, location at the posterior circulation (p < 0.001), familiar intracranial aneurysms (p < 0.001), serum potassium (p = 0.006), and total serum protein (p = 0.019) were related to smaller UIA size in the multivariate analysis. For RIA, a statistically significant and independent association was detected for location (p = 0.019), history of gastrointestinal diseases (p = 0.042), and levothyroxine intake (p = 0.002).
Identification of clinical characteristics related to the size of ruptured and unruptured IA allows a more differentiated view on the genesis of RIA and UIA and the value of sack size as a basis for therapeutic decision-making. More research is needed to verify the identified risk factors.
颅内未破裂动脉瘤（UIA）的大小仍然是治疗决策的最重要危险因素。另一方面，有相当一部分小破裂的 IA 和大的稳定的 UIA。本研究旨在确定与 IA 破裂状态相关的 IA 大小的患者特征。
从我们的机构 IA 数据库中总共纳入了 2152 名患者，其中 1002 名因急性蛛网膜下腔出血（SAH）住院。收集了不同的患者和 IA 的人口统计学和临床特征。IA 大小是本研究的终点，在单变量和多变量线性回归分析中分别作为连续变量进行评估，分别用于破裂的（R）IA 和 UIA。
UIA 和 RIA 亚组的平均 IA 大小分别为 8.3 和 7.3mm。较高的年龄（p=0.003）和基线血尿素水平（p<0.001）与 UIA 大小的增加独立相关。相反，后循环的位置（p<0.001）、家族性颅内动脉瘤（p<0.001）、血清钾（p=0.006）和总血清蛋白（p=0.019）与多变量分析中的 UIA 大小较小相关。对于 RIA，位置（p=0.019）、胃肠道疾病史（p=0.042）和左甲状腺素摄入史（p=0.002）与统计学上显著和独立的相关性检测到。
确定与破裂和未破裂 IA 大小相关的临床特征可以更有区别地了解 RIA 和 UIA 的发生机制以及囊袋大小作为治疗决策基础的价值。需要更多的研究来验证确定的危险因素。
