Increased rupture risk in small intracranial aneurysms associated with methamphetamine use

Area of Science:

• Neurosurgery
• Neurology
• Vascular Neurology

Background:

• Aneurysmal subarachnoid hemorrhage (SAH) is a common cause of nontraumatic bleeding in the brain.
• Current guidelines recommend observation for unruptured intracranial aneurysms under 7 mm, especially in low-risk individuals.

Purpose of the Study:

• To investigate the association between methamphetamine use and the size and location of intracranial aneurysms.
• To determine if methamphetamine users present with ruptured aneurysms at smaller sizes compared to the general population.

Main Methods:

• A retrospective, single-center study was conducted.
• Data from 62 patients with intracranial aneurysms and a history of methamphetamine use were reviewed.
• Aneurysm size, location, and rupture status were the primary focus.

Main Results:

• A total of 73 aneurysms were identified in 62 patients.
• Unruptured aneurysms averaged 5.1 mm, while ruptured aneurysms averaged 6.3 mm.
• 36.5% of aneurysms measuring less than 7 mm presented as SAH, with posterior circulation aneurysms showing a higher rupture rate (70%) compared to anterior circulation (28%).

Conclusions:

• Methamphetamine use is a significant risk factor for aneurysmal SAH, even at smaller aneurysm sizes.
• Patients with a history of methamphetamine use may require a lower threshold for intervention and more intensive surveillance.
• These findings highlight the need for tailored management strategies for intracranial aneurysms in methamphetamine users.