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Configuration of intracranial arteries and development of aneurysms: a follow-up study

A Stijntje E Bor1, Birgitta K Velthuis, Charles B Majoie

  • 1Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, The Netherlands.

Neurology
|February 27, 2008
PubMed

Insights

Intracranial arterial geometry, specifically hypoplastic branches and sharp bifurcation angles, are significant risk factors for developing brain aneurysms. Analyzing these geometric features may help identify individuals at higher risk.

Area of Science:

  • Neuroscience
  • Medical Imaging
  • Biomedical Engineering

Background:

  • The etiology of intracranial aneurysms remains largely unknown, though hemodynamic forces are suspected contributors.
  • Intracranial arterial geometry is increasingly recognized as a potential factor in aneurysm development.

Purpose of the Study:

  • To investigate the association between the geometry of the circle of Willis and the development of intracranial aneurysms.
  • To identify specific geometric features that may serve as risk factors for aneurysm formation.

Main Methods:

  • A cohort study compared the circle of Willis geometry (hypoplasia, bifurcation angles) in 26 aneurysm patients versus 78 matched controls using 3D CTA/MRA.
  • Bifurcation angles were measured and classified into tertiles for statistical analysis.
  • Odds ratios (OR) with 95% confidence intervals (CI) were calculated to assess risk.

Main Results:

  • Hypoplastic arterial branches were significantly more prevalent in patients who developed aneurysms (71%) compared to controls (29%), with an OR of 6.
  • Sharper bifurcation angles (lowest tertile) were also strongly associated with aneurysm development (71% vs. 19%), yielding an OR of 11.3.

Conclusions:

  • Both hypoplastic arterial branches and sharp bifurcation angles at the circle of Willis are identified as significant risk factors for intracranial aneurysm development.
  • Geometric analysis of intracranial arteries shows promise for identifying individuals at elevated risk for aneurysms.
Abstract

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