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Characteristics of Radiation-Related Intracranial Aneurysms: A Multicenter Retrospective Study
Z-Q Huang1, W-J Yang1, G Xiao2
1From the Department of Diagnostic Radiology and Nuclear Medicine (Z.-Q.H., W.-J.Y.), University of Maryland, Baltimore, Maryland.
AJNR. American Journal of Neuroradiology
|March 15, 2023
Summary
Radiation-related intracranial aneurysms occur more frequently in men and younger patients. These aneurysms often present as sidewall types in the internal carotid artery and posterior circulation, with a high prevalence of subarachnoid hemorrhage (SAH).
Area of Science:
- Neurology
- Radiology
- Vascular Surgery
Background:
- Intracranial aneurysms are a rare but serious complication following radiation therapy.
- Previous reports are primarily limited to case studies, necessitating larger investigations into their characteristics.
Purpose of the Study:
- To investigate the distinct characteristics of intracranial aneurysms that develop subsequent to radiation therapy.
- To compare the demographic, clinical, and imaging features of radiation-related aneurysms with non-radiation-related aneurysms.
Main Methods:
- A multicenter, retrospective cohort study was conducted, analyzing data from 4160 patients with intracranial aneurysms.
- Patients with a history of radiation therapy (≥6 months prior) were classified as having radiation-related aneurysms.
- Demographic profiles, clinical presentations (including subarachnoid hemorrhage - SAH), and aneurysm parameters on CTA were compared between radiation-related and control groups.
Main Results:
- Radiation-related aneurysms were identified in 34 patients (0.8%), predominantly affecting men (male-to-female ratio 2.4:1) and younger individuals (mean age 51.4 years) compared to controls.
- A significantly higher proportion of radiation-related aneurysms were sidewall types (46.5%) and involved the internal carotid artery (ICA) and posterior circulation (72.1%).
- Patients with radiation-related aneurysms exhibited a higher prevalence of SAH (88.2%) compared to the control group.
Conclusions:
- Radiation-related intracranial aneurysms demonstrate unique characteristics, occurring more often in younger males and featuring sidewall locations in the ICA and posterior circulation.
- The high prevalence of SAH in this cohort underscores the need for vigilant screening in patients with a history of radiation therapy.
- Further research is required to establish optimal screening protocols, including timing and methodology, for radiation-induced aneurysms.
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