[Intracranial aneurysm in Taiwan]

We reviewed the epidemiologic and clinical features of ruptured intracranial aneurysms based on the available data in the literature reported in Taiwan. Among 28,763 stroke patients registered by members of the Neurological Society of Taiwan, 600 patients had verified intracranial aneurysms (2.1%), constituting only 34.7% of 1,730 patients with subarachnoid hemorrhage. The male to female ratio was 0.68.1. The mean age was 54.6 +/ 14.3 years in men, and 56.5 +/ 13.8 years in women. Among the 409 patients whose aneurysmal sites were recorded, the aneurysm occurred at the anterior communicating artery in 109 (26.7%), at the posterior communicating artery in 90 (22.0%), at the internal carotid artery in 82 (20.1%), at the middle cerebral artery in 80 (19.6%), at the anterior cerebral artery in 50 (12.2%), at the vertebral-basilar system in 13 (3.2%), and multiple sites in 33 (8.1%). Cerebral angiography was performed in 72.2% of patients and operation was undergone in 57.7%. A randomized follow-up study in 59 patients showed survival rates of 63% for 1 month, 53.3% for 6 months and 43.6% for 1 year. The reported surgical mortality rates ranged from 7.7% to 12.5%. Prognosis was related to the score on the World Federation of Neurological Societies Subarachnoid Hemorrhage Scale. In Taiwan, the number of patients with intracranial aneurysm has been underestimated among who have presented with subarachnoid hemorrhage. The high mortality and morbidity of aneurysm rupture justify an aggressive attempt to establish a prompt and accurate diagnosis.