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Impact of aneurysm location on hemorrhage risk

Bradley A Gross1, Pui Man Rosalind Lai1, Rose Du1

  • 1Department of Neurological Surgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston 02115, USA.

Clinical Neurology and Neurosurgery
|July 12, 2014
PubMed

Insights

Aneurysm location significantly impacts rupture risk. Frontopolar/pericallosal, vertebral/PICA, AComm, and PComm aneurysms showed high rupture rates, while SHA, ICA bifurcation, and ophthalmic artery aneurysms had lower rates.

Area of Science:

  • Neurosurgery
  • Vascular Neurology
  • Radiology

Background:

  • Anterior communicating (AComm) artery location is a known risk factor for aneurysm rupture.
  • Posterior circulation/posterior communicating (PComm) artery location is also a significant risk factor.
  • Detailed stratification of aneurysm location and its relation to rupture risk is limited.

Purpose of the Study:

  • To analyze the association between specific intracranial aneurysm locations and their rupture status.
  • To provide a more detailed stratification of aneurysm rupture risk based on precise anatomical location.
  • To inform future studies on aneurysm natural history and risk assessment.

Main Methods:

  • Retrospective review of 747 patients with 1013 aneurysms over a 7-year period.
  • Data collected included aneurysm location and rupture status at presentation.
  • Statistical analysis to determine the odds ratio (OR) and p-values for rupture risk based on location.

Main Results:

  • High rupture proportions were observed for frontopolar/pericallosal (59%), vertebral/PICA (53%), AComm (50%), and PComm (44%) aneurysms.
  • Low rupture proportions were observed for superior hypophyseal artery (SHA) (6%), ICA bifurcation (12%), and ophthalmic artery (15%) aneurysms.
  • Anterior choroidal artery aneurysms showed a significantly higher proportion of rupture compared to non-PComm intradural ICA aneurysms (OR 2.78, p=0.03).

Conclusions:

  • Aneurysm location is a critical determinant of rupture risk.
  • Detailed stratification of aneurysm location is essential for accurate risk assessment.
  • Future research should incorporate granular location data in natural history studies of aneurysms.
Abstract

Keywords:
AneurysmHemorrhageLocationNatural historyRupture

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