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Geometric and Morphologic Features of Ruptured Intracranial Aneurysms Associated with Methamphetamine Use

M Travis Caton1, Jeffrey Vitt2, Eric R Smith1

  • 1Department of Radiology and Biomedical Imaging, Neurointerventional Section, University of California, San Francisco, California, USA.

World Neurosurgery
|May 13, 2022
PubMed
Abstract

Insights

Methamphetamine use in patients with ruptured intracranial aneurysms is linked to a higher aspect ratio, suggesting hazardous remodeling. This finding highlights potential risks associated with methamphetamine in subarachnoid hemorrhage patients.

Area of Science:

  • Neurosurgery
  • Radiology
  • Toxicology

Background:

  • Methamphetamine (MA) use is linked to poor outcomes after aneurysmal subarachnoid hemorrhage (aSAH).
  • The effects of MA on intracranial aneurysm (IA) remodeling are not well understood.
  • This study investigates IA geometric and morphologic features in MA users versus non-users.

Purpose of the Study:

  • To compare IA geometric and morphologic features in patients with and without methamphetamine (MA) detected via urine toxicology (Utox).
  • To determine if MA use is associated with specific IA remodeling patterns.

Main Methods:

  • Retrospective review of 160 patients with SAH and Utox at admission.
  • Blinded neuroradiologists assessed IA characteristics including diameter, volume, ratios, and morphology.
  • Statistical analysis compared features between MA-positive and MA-negative groups.

Main Results:

  • 16.5% of patients were Utox MA+; no differences in aneurysm subtype, blebs, vasculopathy, or additional aneurysms.
  • Maximum IA sac diameter, ellipsoid volume, dome-neck ratio, and size ratio were similar between groups.
  • A significantly higher aspect ratio (AR) was observed in the MA+ group (2.20 vs. 1.74, P=0.02), and AR predicted MA+ status.

Conclusions:

  • Active methamphetamine use is independently associated with a larger aspect ratio in ruptured intracranial aneurysms.
  • This altered AR may indicate hazardous IA remodeling due to hemodynamic and/or inflammatory changes.
  • Further research is needed to elucidate the mechanisms behind MA-associated IA remodeling.
Keywords:
AneurysmAneurysm morphologyMethamphetamineStimulantSubarachnoid hemorrhageUrine toxicology

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