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Prevalence and Characteristics of Unruptured Cerebral Aneurysms in Ischemic Stroke Patients

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Background and Purpose The prevalence of unruptured cerebral aneurysms (UCAs) in ischemic stroke patients is not clearly defined. This study aimed to measure the prevalence and characteristics of UCAs in patients with acute ischemic stroke (AIS) and to compare our findings with those of the general population. In addition, we investigated the factors associated with cerebral aneurysms in AIS patients. Methods We retrospectively reviewed the brain magnetic resonance angiography images of 955 patients with AIS and 2,118 controls who had received a brain magnetic resonance angiography as part of a health check-up. We investigated the prevalence, size, location, and risk factors of the subjects in the context of UCAs. Results UCAs were found in 74 patients with AIS (7.7%) and in 79 who received a health check-up (3.7%). The prevalence of UCAs was significantly higher in the AIS group than in the health check-up group (odds ratio 2.17, 95% confidence interval 1.56-3.01). The mean aneurysm diameter was larger in the AIS group than in the health check-up group (3.75 mm vs. 3.02 mm, P=0.009). UCAs were primarily located in the internal carotid artery in both groups, and aneurysms in the middle cerebral artery were particularly common in the AIS group. According to multivariate analysis, hypertension alone was associated with an increased prevalence of UCAs in stroke patients. Conclusions This study identified a higher prevalence and larger size of UCAs in AIS patients than in the general population. Hypertension was an independent risk factor of UCA in AIS.

Abstract

Background and Purpose The prevalence of unruptured cerebral aneurysms (UCAs) in ischemic stroke patients is not clearly defined. This study aimed to measure the prevalence and characteristics of UCAs in patients with acute ischemic stroke (AIS) and to compare our findings with those of the general population. In addition, we investigated the factors associated with cerebral aneurysms in AIS patients. Methods We retrospectively reviewed the brain magnetic resonance angiography images of 955 patients with AIS and 2,118 controls who had received a brain magnetic resonance angiography as part of a health check-up. We investigated the prevalence, size, location, and risk factors of the subjects in the context of UCAs. Results UCAs were found in 74 patients with AIS (7.7%) and in 79 who received a health check-up (3.7%). The prevalence of UCAs was significantly higher in the AIS group than in the health check-up group (odds ratio 2.17, 95% confidence interval 1.56-3.01). The mean aneurysm diameter was larger in the AIS group than in the health check-up group (3.75 mm vs. 3.02 mm, P=0.009). UCAs were primarily located in the internal carotid artery in both groups, and aneurysms in the middle cerebral artery were particularly common in the AIS group. According to multivariate analysis, hypertension alone was associated with an increased prevalence of UCAs in stroke patients. Conclusions This study identified a higher prevalence and larger size of UCAs in AIS patients than in the general population. Hypertension was an independent risk factor of UCA in AIS.

참고문헌 (38)

  1. Brisman JL, "Cerebral aneurysms", N Engl J Med, 355, pp.928~939 (2006)
  2. van Gijn J, "Subarachnoid hemorrhage", Lancet, 369, pp.306~318 (2007)
  3. Wiebers DO, "Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment", Lancet, 362, pp.103~110 (2003)
  4. Morita A, "The natural course of unruptured cerebral aneurysms in a Japanese cohort", N Engl J Med, 366, pp.2474~2482 (2012)
  5. Juvela S, "Natural history of unruptured intracranial aneurysms : a long-term follow-up study", Stroke, 44, pp.2414~2421 (2013)
  6. Etminan N, "Multidisciplinary consensus on assessment of unruptured intracranial aneurysms : proposal of an international research group", Stroke, 45, pp.1523~1530 (2014)
  7. Rinkel GJ, "Prevalence and risk of rupture of intracranial aneurysms : a systematic review", Stroke, 29, pp.251~256 (1998)
  8. Brown RD Jr, "Unruptured intracranial aneurysms: epidemiology, natural history, management options, and familial screening", Lancet Neurol, 13, pp.393~404 (2014)
  9. Vlak MH, "Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis", Lancet Neurol, 10, pp.626~636 (2011)
  10. Atkinson JL, "Angiographic frequency of anterior circulation intracranial aneurysms", J Neurosurg, 70, pp.551~555 (1989)
  11. Vernooij MW, "Incidental findings on brain MRI in the general population", N Engl J Med, 357, pp.1821~1828 (2007)
  12. Li MH, "Prevalence of unruptured cerebral aneurysms in Chinese adults aged 35 to 75 years : a cross-sectional study", Ann Intern Med, 159, pp.514~521 (2013)
  13. Muller TB, "Unruptured intracranial aneurysms in the Norwegian Nord-Trøndelag Health Study(HUNT) : risk of rupture calculated from data in a population-based cohort study", Neurosurgery, 73, pp.256~261 (2013)
  14. Igase K, "Initial experience in evaluating the prevalence of unruptured intracranial aneurysms detected on 3-tesla MRI", Cerebrovasc Dis, 33, pp.348~353 (2012)
  15. Kojima M, "Asymptomatic familial cerebral aneurysms", Neurosurgery, 43, pp.776~781 (1998)
  16. Winn HR, "Prevalence of asymptomatic incidental aneurysms : review of 4568 arteriograms", J Neurosurg, 96, pp.43~49 (2002)
  17. Horikoshi T, "Retrospective analysis of the prevalence of asymptomatic cerebral aneurysm in 4518 patients undergoing magnetic resonance angiography—when does cerebral aneurysm develop?", Neurol Med Chir (Tokyo), 42, pp.105~112 (2002)
  18. Adams HP, Jr, "Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment", Stroke, 24, pp.35~41 (1993)
  19. Mizutani T, "Proposed classification of nonatherosclerotic cerebral fusiform and dissecting aneurysms", Neurosurgery, 45, pp.253~259 (1999)
  20. 전태연, "Prevalence of Unruptured Intracranial Aneurysm on MR Angiography", Korean Journal of Radiology, 12(5), pp.547~553 (2011), 대한영상의학회
  21. 박순찬, "Incidental Saccular Aneurysms on Head MR Angiography: 5 Years’ Experience at a Single Large-Volume Center", 대한뇌졸중학회지, 16(3), pp.189~194 (2014), 대한뇌졸중학회[DOI]
  22. Iwamoto H, "Prevalence of intracranial saccular aneurysms in a Japanese community based on a consecutive autopsy series during a 30-year observation period. The Hisayama study", Stroke, 30, pp.1390~1395 (1999)
  23. Tominari S, "Prediction model for 3-year rupture risk of unruptured cerebral aneurysms in Japanese patients", Ann Neurol, 77, pp.1050~1059 (2015)
  24. Juvela S, "Risk factors for all-cause death after diagnosis of unruptured intracranial aneurysms", Neurology, 84, pp.456~463 (2015)
  25. Chalouhi N, "Review of cerebral aneurysm formation, growth, and rupture", Stroke, 44, pp.3613~3622 (2013)
  26. Bacigaluppi S, "Factors affecting formation and rupture of intracranial saccular aneurysms", Neurosurg Rev, 37, pp.1~14 (2014)
  27. Greving JP, "Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms : a pooled analysis of six prospective cohort studies", Lancet Neurol, 13, pp.59~66 (2014)
  28. Hokari M, "The impact of atherosclerotic factors on cerebral aneurysm is location dependent : aneurysms in stroke patients and healthy controls", J Stroke Cerebrovasc Dis, 23, pp.2301~2307 (2014)
  29. Kang HG, "Risk factors associated with the presence of unruptured intracranial aneurysms", Stroke, 46, pp.3093~3098 (2015)
  30. Héman LM, "Incidental intracranial aneurysms in patients with internal carotid artery stenosis : a CT angiography study and a metaanalysis", Stroke, 40, pp.1341~1346 (2009)
  31. Liang Y, "Coexistence of internal carotid artery stenosis with intracranial aneurysm", Int J Stroke, 9, pp.306~307 (2014)
  32. Cho YD, "Characteristics of intracranial aneurysms associated with extracranial carotid artery disease in South Korea", Clin Neurol Neurosurg, 115, pp.1677~1681 (2013)
  33. Chaturvedi S, "How recent data have impacted the treatment of internal carotid artery stenosis", J Am Coll Cardiol, 65, pp.1134~1143 (2015)
  34. Goessens BM, "Asymptomatic carotid artery stenosis and the risk of new vascular events in patients with manifest arterial disease : the SMART study", Stroke, 38, pp.1470~1475 (2007)
  35. Tejada J, "Does a relationship exist between carotid stenosis and lacunar infarction?", Stroke, 34, pp.1404~1409 (2003)
  36. Li MH, "Accurate diagnosis of small cerebral aneurysms ≤5 mm in diameter with 3.0-T MR angiography", Radiology, 271, pp.553~560 (2014)
  37. Sailer AM, "Diagnosing intracranial aneurysms with MR angiography : systematic review and meta-analysis", Stroke, 45, pp.119~126 (2014)
  38. Li MH, "Contrast-free MRA at 3.0 T for the detection of intracranial aneurysms", Neurology, 77, pp.667~676 (2011)

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