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Multiple and mirror intracranial aneurysms: study of prevalence and associated risk factors

Jefferson Rosi Junior1, Alexandra Gomes Dos Santos1, Saul Almeida da Silva1

  • 1Division of Neurological Surgery, Hospital das Clinicas, University of São Paulo Medical School, Sao Paulo, Brazil.

British Journal of Neurosurgery
|November 9, 2020
PubMed
Abstract

Insights

Female sex, smoking, and advanced age are key risk factors for multiple intracranial aneurysms (MIA). These factors, already linked to single aneurysms, show a proportional increase in patients with MIA, highlighting their significance in complex cerebrovascular conditions.

Area of Science:

  • Neuroscience
  • Vascular Neurology
  • Epidemiology

Background:

  • Multiple intracranial aneurysms (MIA) represent a significant portion of all intracranial aneurysms.
  • Mirror aneurysms, a specific subtype of MIA, occur in a notable percentage of patients with cerebral aneurysms.

Purpose of the Study:

  • To investigate the risk factors associated with the presence of multiple and mirror intracranial aneurysms.
  • To identify demographic and clinical factors contributing to the development of MIA.

Main Methods:

  • A cohort of 1404 patients diagnosed with intracranial aneurysms via digital subtraction angiography (DSA) was analyzed.
  • Patient characteristics including sex, age, smoking status, hypertension, and oral contraceptive use were evaluated.
  • Multiplicity was defined as two or more aneurysms; mirror aneurysms were defined as a pair involving bilateral corresponding arteries.

Main Results:

  • 36.4% of patients had MIA, with 13% having mirror aneurysms.
  • Female sex, smoking, and advanced age were significantly associated with MIA.
  • Females had a higher frequency of both multiple (OR=1.883) and mirror aneurysms (OR=2.828).
  • Smoking (OR=1.458) and advanced age (OR=1.938) were associated with multiplicity.
  • No significant association was found between mirror aneurysms and smoking or advanced age.
  • Aneurysm size varied, with smaller aneurysms more frequent in MIA patients and giant aneurysms in single aneurysm patients.
  • Hypertension and oral contraceptive use showed no significant association with aneurysm multiplicity.

Conclusions:

  • Known risk factors for single intracranial aneurysms, such as female gender and smoking, are proportionally increased in patients with MIA.
  • Hypertension and oral contraceptive use were not found to be associated with aneurysm multiplicity in this study.
  • The findings underscore the importance of sex, smoking, and age in the development of multiple and mirror intracranial aneurysms.
Keywords:
Multipleaneurysmsintracranialmirror

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