gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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A scoring system for the identification of the ruptured aneurysm in patients with aneurysmal subarachnoid hemorrhage and multiple intracranial aneurysms

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  • Alexis Hadjiathanasiou - Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Thomas Welchowski - Institut für Medizinische Biometrie, Informatik und Epidemiologie, Bonn, Deutschland
  • Matthias Schmid - Institut für Medizinische Biometrie, Informatik und Epidemiologie, Bonn, Deutschland
  • Simon Brandecker - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Bonn, Deutschland
  • Patrick Schuss - Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Hartmut Vatter - Rheinische Friedrich-Wilhelms-Universität, Neurochirurgische Klinik, Bonn, Deutschland
  • Erdem Güresir - Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMO.13.06

doi: 10.3205/17dgnc075, urn:nbn:de:0183-17dgnc0757

Published: June 9, 2017

© 2017 Hadjiathanasiou et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: 20% of patients suffering from aneurysmal subarachnoid hemorrhage (SAH) are harboring multiple intracranial aneurysms (MIAs). However, identifying the ruptured aneurysm in patients with MIAs can be challenging. Therefore, we developed a statistical model for the prediction of the ruptured aneurysm in patients with SAH and multiple potential bleeding sources at the time of SAH ictus.

Methods: Between 2012-2015, 424 patients harboring 791 aneurysms were admitted to the authors institution. Patients were included in a prospectively conducted database. Aneurysm and patient characteristics, as well as radiological findings were included and analyzed. A generalized, additive boosting model was used for analysis.

Results: According to the statistical prediction model the main factors used for assessing the rupture score in patients harboring multiple aneurysms were: 1) aneurysm size, 2) aneurysm localization and 3) aneurysm shape. A simplified version of the scoring system was produced for the use in the clinical setting. A score for each aneurysm is calculated according to these three factors. The aneurysm with the highest score poses the highest possibility of being the bleeding source.

Conclusion: This new and simple prediction tool might provide support for neurovascular teams for treatment decision in SAH patients harboring multiple aneurysms. However, prospective evaluation is necessary.