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Giant intracranial aneurysms: morphology and clinical presentation
Marcio L Tostes dos Santos1, Antonio Ronaldo Spotti, Rosangela M Tostes dos Santos
1Department of Neurological Sciences, Medical School of São José do Rio Preto, São José do Rio Preto, SP, Brazil. neurocirurgiaendovascular@yahoo.com.br
Neurosurgical Review
|July 14, 2012
Summary
Giant intracranial aneurysms (GIA) morphology correlates with rupture risk. Poor quality communicating arteries and absence of thrombus/calcification significantly increase GIA rupture likelihood.
Area of Science:
- Neurosurgery
- Radiology
- Pathology
Background:
- Giant intracranial aneurysms (GIA) are complex vascular lesions with significant morbidity and mortality.
- Understanding GIA morphology is crucial for predicting rupture risk and guiding treatment strategies.
Purpose of the Study:
- To correlate the morphological characteristics of giant intracranial aneurysms (GIA) with their clinical presentation and rupture status.
- To identify specific morphological features associated with an increased risk of GIA rupture.
Main Methods:
- Retrospective analysis of 80 patients diagnosed with GIA.
- Univariate and multivariate statistical analyses to assess associations between morphological features (e.g., thrombus, calcification, communicating artery quality) and clinical presentation (ruptured vs. unruptured).
Main Results:
- GIA most frequently occurred in the carotid cavernous segment (unruptured) and carotid supraclinoid/middle cerebral arteries (ruptured).
- A significant association was found between poor quality communicating arteries (CA) and the presence of thrombus and calcification (TC).
- Patients with poor quality CA had an 8-fold higher risk of rupture, while those without TC had an 11-fold higher risk.
Conclusions:
- GIA location varies between ruptured and unruptured cases, with the middle cerebral artery posing a high rupture risk.
- Morphological features like communicating artery quality and the absence of thrombus/calcification are critical indicators of GIA rupture risk.
- These findings aid in risk stratification and clinical decision-making for GIA management.
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