Incidence and Clinical Hallmark of Brain Tumors and Cerebral Aneurysms on Repeated Brain Check-up.

Abstract

Listen

Translate article

Background The incidence of brain tumors or cerebral aneurysms remains unknown on repeated brain check-up.Purpose We studied the incidence of brain tumors or cerebral aneurysms in large number of individuals who reccceived brain checkup more than twice in PL Tokyo Health Care Center, Japan.Method In our center, 9, 538 participants received brain check-up between August 1995 and July 2002. We analyzed 2, 175 participants (1, 598 men and 577 women) who had brain and physical check-ups more than 2 times. Mean age of subjects was 53.4 (SD 10.4) years in all, 53.1 (SD 10.3) years in men and 54.2 (SD 10.6) years in women. Subjects who were diagnosed as brain tumors or cerebral aneurysms on the first brain check-up were excluded. Brain check-up was produced by 1.5-tesla superconducting system (Stratis II, Hitachi Medical, Japan) . Conventional magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) using three-dimension time-of-flight sequence were undertaken in all subjects. The incidence and the clinical features of brain tumors or cerebral aneurysms were studied.Results The frequency of repeated brain check-up was 22.8%. The intervals between brain check-ups were 277 to 728 days. The times of brain check-up were two to sex. The analysis of brain tumor was diagnosed as meningioma in one woman. The incidence of brain tumors was 0.05% in total subjects and 0.17% in women. The duration between the first and the 2nd brain check-up was one year in this case. Cerebral aneurysms were seen in 6 subjects (2 men and 4 women) . All subjects had no clinical symptoms without a family history of subarachnoid hemorrhage. The total number of aneurysms was 8. Aneurysms were located in the internal carotid artery (n=2), the anterior cerebral arteries (n=3), the middle cerebral artery (n=3) and the basilar artery (n=1) . Two women had two aneurysms. The incidence of aneurysms was 0.28% in total subjects, 0.13% in men and 0.69% in women. The mean age of subjects with aneurysms was 57.7 (SD 6.7) years in all, 64.0 (SD 6.7) years in men, and 54.5 (SD 5.4) years in women. The interval between the first and the 2nd brain check-up was one to five years and the mean duration was 3.0 years (SD 1.7) in 6 subjects with aneurysms. The prognosis was excellent in those five subjects. Subarachnoid hemorrhage occurred in one woman with multiple aneurysms although we strongly recommended neurosurgical procedures for enlarging aneurysms.Conclusion The underdiagnosis of brain tumors and cerebral aneurysms on the first brain check-up contributed to sizes and portions of lesions, radiological technique and reviewers of neuroim-ages. To make the early and correct diagnosis of both fatal diseases, we should compare between the initial and repeated data, including resource imaging of MRA. Radiological technicians always investigate the monitor of MRI and MRA. Cooperation with neurological reviewers and radiological technicians is important to make the early diagnosis of brain tumors and cerebral aneurysms. Our stud-ies indicate that brain check-up should be repeated within a few years, in order to discover asymptomatic brain tumors and unrup-tured aneurysms.