Prevalence Of Cerebral Aneurysms Research Articles

The Prevalence of Cerebral Aneurysms in Patients with Polycystic Liver Disease

"Background: It is well known that patients with polycystic kidney disease (PKD) are at increased risk of developing cerebral aneurysms, however, this association has not been well studied for patients with polycystic liver disease (PLD). Material and methods: Cross-sectional descriptive study, which included 15 adult patients diagnosed with polycystic liver disease at the Gastroenterology and Hepatology Department of Fundeni Clinical Institute. Standard neurological exam and brain MRI were performed in all patients on a 1.5 Tesla MRI. Brain imaging protocol included T1/T2, T1SE, T2-FLAIR, DWI, SWI, 2D-TOF, 3D-TOF. Results: The majority of patients (93%) were females. The mean age was 53 ± 5 years old. Patients with AD-PKD and polycystic hepatic disease predominated (60%). Aneurysms were found in only one patient diagnosed with AD-PKD (in whom three aneurysms were described). The overall prevalence of cerebral aneurysms in our patient group was 7%. However, none of the patients with isolated PLD was found to have intracranial aneurysms. Other brain imaging abnormalities were frequent but nonspecific (mostly attributable to vascular-degenerative changes). Conclusions: Given these results, and due to the small number of patients in our study, it is hard to appreciate if polycystic liver disease is indeed associated with an increased risk of cerebral aneurysms. "

Prevalence of cerebral aneurysms in autopsy studies: a review of the literature.

Cerebral aneurysms (CAs) are one of the most important causes of stroke, but details of their prevalence remain under-researched. Autopsy data for CAs were reviewed using standard search engines. Based on previously published autopsy and clinical studies, the prevalence of CAs with respect to age, gender, and aneurysm site, size, and multiplicity was investigated, and the natural course of CA prevalence was estimated. In autopsy studies, the prevalence of CAs across all age groups was 0.3-4.0% for unruptured cerebral aneurysms (UCAs) and 1.3-7.6% for CAs including UCAs and ruptured cerebral aneurysms (RCAs). Patients with UCAs were generally older than those with RCAs. Middle cerebral artery aneurysms were more predominant in autopsy studies than in clinical studies. UCAs tended to be smaller than RCAs, and minute UCAs (< 2mm), diagnosed microscopically at autopsy and thought to be in the very early stages of formation, were present in 10-20% of the general population. Taking into consideration the clinical data for UCAs and RCAs, 10% of minute UCAs enlarge to major UCAs (≥ 2mm) detectable by conventional imaging techniques, and 10% of major UCAs eventually rupture within 10years. The high prevalence of UCAs and RCAs in the elderly and women can be attributed to the more frequent occurrence of minute UCAs in these populations. Minute UCAs occur at a high rate, but only a few enlarge to become major UCAs and rupture. Further advances in diagnostic technology are essential for revealing the true natural course of CA prevalence.

Prevalence of cerebrovascular diseases that can cause hemorrhagic stroke in liver transplantation recipients: a 6-year comparative study with 24,681 healthy adults.

Cerebrovascular diseases are a leading cause of mortality after liver transplantation (LT). The prevalence of potentially hemorrhagic cerebrovascular diseases (HCVDs) that could cause a hemorrhagic stroke in patients with severe liver diseases has not been reported. We aimed to analyze the underlying prevalence of HCVDs that could lead to hemorrhagic strokes in LT recipients compared with that in previously healthy controls. A retrospective study with 1,920 consecutive LT recipients and 24,681 adults who underwent a health checkup during the same period was conducted (January 2011-December 2016). The prevalence of cerebral aneurysms (CA), cerebral arteriovenous malformation (AVM), and cavernous malformation (CM) was evaluated using brain imaging, including computed tomography angiography, magnetic resonance imaging, magnetic resonance angiography, and digital subtraction angiography. The prevalence of CA and CM were 3.1% and 0.5%, respectively, in the LT group and 3.8% and 0.4%, respectively, in the control group. According to the location of the cerebral artery, paraclinoid internal carotid artery aneurysms (odds ratio [OR] 0.440; P = 0.009) had a lower prevalence in LT recipients than in healthy controls. Anterior communicating artery (OR 3.080; P = 0.002) and superior cerebellar artery (OR 8.767; P = 0.017) aneurysms had a higher prevalence in the LT group than in the control. The prevalence of AVM was significantly higher in LT recipients (0.26%) than in healthy controls (0.06%). LT recipients showed a different distribution of CA prevalence according to the locations of the cerebral artery and had a higher overall prevalence of AVM than previously healthy controls.

Abstract 43: Characteristics of Intracranial Cerebral Aneurysms According to the Coronary Artery Calcium

Introduction: Several vascular risk factors are known to be associated with the presence of intracranial cerebral aneurysm. Coronary artery calcium (CAC) which reflects the atherosclerotic burden of coronary artery is a known predictor of cardiovascular event and stroke. We investigated the relationship between cerebral aneurysm and CAC. Methods: We retrospectively enrolled subjects who had both brain magnetic resonance angiography and cardiac computed tomography as part of health examinations from January 2010 to July 2017. Subjects were categorized into four groups according to the CAC score by cardiac computed tomography; none (0), low (1-99), intermediate (100-399) and high (&gt; 400). The prevalence of cerebral aneurysm according to the CAC score groups was assessed. We also performed subgroup analysis by the sex, age and location of intracranial cerebral aneurysm. Results: Total 4934 subjects (age 54.1 ± 9.8 years, female 42.2%) were included for analysis. Cerebral aneurysms were detected in 258 subjects (5.23%). The prevalence of cerebral aneurysm was significantly increased as the CAC score increased (4.8%, 5.4%, 6.4% and 11.1%, respectively, p for trend = 0.004). This correlation was more prominent in women than in men over the age of 50 (7.1% vs 3.7, 8.8% vs 4.4%, 8.6% vs 6.3%, and 21.1% vs 10.0%, respectively). As to the aneurysm location, non-bifurcation aneurysm was more common than bifurcation aneurysm in high CAC score group (p=0.02). In multivariate analysis, the group of high CAC score had significantly more cerebral aneurysm than group of no CAC score (adjust odds ratio = 2.16, 95% confidence interval 1.18-3.95). Conclusions: CAC which reflects coronary artery atherosclerosis is also an important risk factor of intracranial cerebral aneurysm. This correlation is more prominent in female and non-bifurcation aneurysm.

Safety Assessment of Endovascular Treatment of Cerebral Aneurysms in Patients with Fibromuscular Dysplasia

Background: The prevalence of cerebral aneurysms is increased in fibromuscular dysplasia (FMD). The presence of FMD may serve as discouragement to elective endovascular aneurysm treatment. Outcomes of endovascular intervention for aneurysms through vessels affected by FMD have not been reported. Methods: A prospectively maintained database of patients undergoing intracranial embolization was reviewed for patients with FMD who underwent endovascular aneurysm treatment. Results: A total of 1,025 patients were screened and 31 (3.0%) had cerebrovascular FMD. These patients underwent a total of 43 embolization procedures; 27 of these procedures were performed through an affected vessel. All but 1 patient were female and the average age was 62 years. “String-of-pearls”-type FMD was the most common subtype (90%). The internal carotid arteries were more commonly affected (65%) than the vertebral arteries (48%). All patients underwent treatment of cerebral aneurysms, most of which (87%) were incidentally discovered; 6 patients (19%) also had incidental vessel dissection. The average aneurysm size was 7.1 mm. The morphology was saccular in 93% of the cases, and 86% were in the anterior circulation. The most commonly performed treatment was flow diversion (67%), in the majority of cases by pipeline embolization. Other procedures performed were coiling (19%), stent-coiling (12%), and intrasaccular flow disruption (2%). All but 1 procedure (98%) were successful. There were no major complications; 1 patient experienced a transient ischemic attack. Follow-up angiography was performed in 88% of the cases, without evidence for disease progression after treatment. The average time to last angiographic follow-up was 17 months (±13). Conclusions: Elective embolization of intracranial aneurysms can be performed safely through vessels affected by FMD.

Endothelialization of Platinum-Based Coils: A New Frontier of Endosaccular Aneurysm Therapy

he prevalence of cerebral aneurysms is estimated to be 1%e2% (14, 15, 17) in the general population. TheraT peutic options include microsurgical clipping and endovascular embolization, both of which share the common goal of excluding the aneurysm from the circulation to eradicate the risk of rupture (or recurrent rupture). The advent of platinum-based detachable coils revolutionized the management of intracranial aneurysms (3, 4). Publication of the International Subarachnoid Aneurysm Trial (8, 9) not only led to a paradigm shift for aneurysm treatment but also propelled endovascular therapy to the forefront of cerebrovascular diseases (5, 12). Additional prospective studies further established the superiority of endovascular coiling in terms of reducing death and dependency (6), as well as cognitive dysfunction (16).