• Medicine · Nov 2024

    Observational Study

    Ruptured middle cerebral artery bifurcation aneurysms with concomitant intracerebral hematoma: Clinical and morphological risk factors.

    • Rifat Akdağ and Uğur Soylu.
    • Department of Neurosurgery, Yüksek İhtisas Training and Research Hospital, Bursa, Turkey.
    • Medicine (Baltimore). 2024 Nov 29; 103 (48): e40693e40693.

    AbstractThe prognosis for intracerebral hematoma (ICH) following the rupture of a middle cerebral artery bifurcation (Mbif) aneurysm is poor. We compared patients with isolated diffuse subarachnoid hemorrhage (SAH) (without ICH) following Mbif aneurysm rupture to those with both SAH and ICH to evaluate clinical and morphological risk factors for ICH. A retrospective study was conducted on 112 patients with ruptured Mbif aneurysms treated between July 2016 and December 2021. We investigated age, sex, medical history (hypertension, diabetes mellitus, and smoking), rebleeding, aneurysm neck and dome size, bottleneck factor, aspect ratio, dome projection, trunk diameters and ratios, parent artery (M1) dimensions, angles between both trunks (γ1, γ2, γ3), as well as M1 length and diameter, and internal carotid artery/M1 (α) and internal carotid artery/anterior cerebral artery (β) angles. These measurements were obtained using computerized tomography angiography to assess risk factors. A total of 88 patients (78.6%) with ruptured Mbif aneurysms who met the inclusion criteria were included in the study. A total of 39 (44.3%) patients had SAH with ICH, while 49 (53.7%) patients had pure diffuse SAH. Rebleeding was significantly higher in patients with ICH (P = .02). Morphological analysis revealed that the decrease in M1 diameter and α angle, along with an increase in aneurysm size and neck, were significantly different in the ICH group (P = .025, P = .012, P = .009, and P = .005, respectively). Receiver operating characteristic curve analysis showed that a cutoff value of α = 125° had the highest diagnostic accuracy (area under the curve = 0.71), with a sensitivity of 86.26% and specificity of 68.7%. The formation of ICH following the rupture of Mbif aneurysms is associated with specific morphological parameters.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…