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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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Influence of morphological vascular parameters and the anatomical variations of the Sylvian Fissure on the bleeding pattern of ruptured middle cerebral artery aneurysms

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  • Homajoun Maslehaty - Kiel, Deutschland
  • Roman Frantsev - Essen, Deutschland
  • Bernadette Kleist - University Hospital Essen, Department of Neurosurgery, Essen, Deutschland
  • Bernd Otto Hütter - Essen, Deutschland
  • Ulrich Sure - Universitätsklinikum Essen der Universität Duisburg-Essen, Klinik und Poliklinik für Neurochirurgie, Essen, Deutschland
  • Oliver M. Müller - Universitätsklinikum Essen der Universität Duisburg-Essen, Klinik und Poliklinik für Neurochirurgie, Essen, 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. DocP 213

doi: 10.3205/17dgnc776, urn:nbn:de:0183-17dgnc7764

Published: June 9, 2017

© 2017 Maslehaty 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: The aim of the study was to analyse the influence of the morphological variations of the Sylvian Fissure (SF) and vascular parameters on occurrence of different bleeding patterns in patients with ruptured middle cerebral artery (MCA) aneurysms.

Methods: We analysed the data of patients with ruptured MCA aneurysm of the past ten years. The patients were divided into two groups. Group 1 with subarachnoid hemorrhage (SAH) and group 2 with accompanied intra-cerebral hemorrhage (ICH). The SF was classified in five types according to the previously described classification. The vascular parameters, which were analysed in the study, were size, localization, presence of a daughter aneurysm, angulation and shape of the aneurysm. SPSS 23.0 for Windows was used for statistical analysis.

Results: N=193 patients were included to this study with a mean age of 51.6 years. N=76 (39.4%) patients had a SAH and n=117 (61.6%) presented with accompanied ICH. Univariate analysis showed only a significant association of the SF types to the different bleeding patterns. Types 1-3 were associated more frequently with the presence of SAH and types 4&5 more frequently with SAH with accompanied ICH. The other determined parameters were not significant. Logistic regression analysis showed that the type of the SF was the most powerful predictor for occurrence of the different bleeding patterns.

Conclusion: The role of the anatomical configuration of the SF on the bleeding pattern of ruptured MCA aneurysms is an issue, which is not examined yet in the literature. The results of our study confirmed our hypothesis that a narrow and twisted SF configuration forwards the presence of ICH with statistical significance. In contrast, different vascular parameters alone had no significant influence on the occurrence of the bleeding pattern.