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Sex Differences in Intracranial Aneurysms: A Matched Cohort Study
Vanessa M Swiatek1, Amir Amini1, Michelle Marinescu1
1Department of Neurosurgery, Otto-von-Guericke University, 39120 Magdeburg, Germany.
Journal of Personalized Medicine
|October 25, 2024
Summary
This study found no sex differences in rupture rates or outcomes for intracranial aneurysms (IAs). However, women showed a higher prevalence of multiple IAs and distinct localization patterns, suggesting complex sex influences on IA development.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Radiology
Background:
- Aneurysmal subarachnoid hemorrhage (SAH) disproportionately affects women, with higher risks and prevalence of intracranial aneurysms (IAs) after age 50.
- Women face increased risks of IA growth and rupture compared to men.
- Existing research suggests sex influences IA development and rupture, but clinical outcomes require further clarification.
Purpose of the Study:
- To investigate the independent impact of sex on IA rupture rates, bleeding severity, and functional outcomes.
- To analyze sex-specific differences in IA localization and multiplicity.
- To utilize a matched cohort to isolate the influence of sex on clinical and morphological characteristics of IAs.
Main Methods:
- Retrospective analysis of 300 patients with 511 IAs, including clinical data and 3D angiography.
- Matched cohort design comparing female and male patients based on clinical parameters and 21 morphological IA characteristics.
- Interactive visual exploration tool employed for multidimensional matching of patient cohorts.
Main Results:
- No significant sex differences were observed in IA rupture rates or vasospasm.
- Severity of SAH, functional outcomes, and complications like hydrocephalus were similar between sexes.
- Women demonstrated a higher prevalence of multiple IAs and unique localization patterns compared to men.
Conclusions:
- While biological sex influences IA characteristics and localization, it does not appear to significantly impact clinical outcomes or rupture rates in this matched cohort.
- Distinct patterns in IA multiplicity and location in women warrant further investigation into sex-specific biological factors.
- Additional research is crucial to fully understand the complex interplay of sex in IA development, rupture, and management.
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