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Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
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Cerebral Microbleeds Could Be Independently Associated with Intracranial Aneurysm Rupture: A Cross-Sectional

Xin Zhang1, Zhi-Qiang Yao2, Tamrakar Karuna3

  • 1National Key Clinical Specialty/Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Neurosurgery Institute, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China.

World Neurosurgery
|April 15, 2018
PubMed
Abstract

Insights

Cerebral microbleeds (CMBs) are independently linked to a higher risk of intracranial aneurysm rupture. Patients with CMBs face a 60% increased risk, with ruptures occurring most often within 9.5 months.

Area of Science:

  • Neurology
  • Radiology
  • Vascular Surgery

Background:

  • Intracranial aneurysms pose a significant risk of rupture, leading to subarachnoid hemorrhage.
  • Cerebral microbleeds (CMBs) are small lesions often detected via MRI, but their association with aneurysm rupture is not fully understood.

Purpose of the Study:

  • To investigate the independent association between cerebral microbleeds (CMBs) and intracranial aneurysm rupture.
  • To determine the time interval during which CMBs increase the risk of aneurysm rupture.

Main Methods:

  • A cross-sectional study analyzed 1847 patients with intracranial aneurysms (unruptured and ruptured) from 2010-2017.
  • Preoperative MRI (T2-weighted gradient-recalled echo) identified CMBs. Univariate and multivariate logistic regression assessed rupture risk factors.
  • Follow-up data was collected for patients with CMBs to evaluate rupture incidence and timing.

Main Results:

  • Cerebral microbleeds (CMBs) were present in 7.7% of patients (142/1847).
  • The incidence of CMB-related aneurysm rupture during follow-up was 27.9% (24/86), with a median time to rupture of 9.5 months (range: 3-27 months).
  • Multivariate analysis confirmed CMBs as a significant independent predictor of aneurysm rupture (OR=1.6, P=0.010).

Conclusions:

  • Cerebral microbleeds (CMBs) are independently associated with an increased risk of intracranial aneurysm rupture.
  • Patients with CMBs exhibit a 60% higher likelihood of aneurysm rupture compared to those without CMBs.
Keywords:
CMBsIntracranial aneurysmRiskRupture

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