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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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Risk factors and clinical consequences of multiple intracranial aneurysms: A systematic review and meta-analysis

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  • Ramazan Jabbarli - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
  • Thiemo Florin Dinger - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
  • Marvin Darkwah Oppong - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
  • Daniela Pierscianek - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
  • Philipp Dammann - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
  • Karsten H. Wrede - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
  • Ulrich Sure - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocV005

doi: 10.3205/18dgnc005, urn:nbn:de:0183-18dgnc0055

Published: June 18, 2018

© 2018 Jabbarli 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: Multiple intracranial aneurysms (MIA) are common findings of cerebral angiographies; however, MIA prevalence varies in different patient cohorts.We sought to elucidate risk factors influencing MIA prevalence and the clinical consequences.

Methods: We systematically searched PubMed, Scopus, Embase and Cochrane Library databases for publications before Jan 15, 2017 on MIA prevalence and risk factors. We used random-effects meta-analysis, and multivariate regression analysis to assess the impacts of individual, study and population characteristics.

Results: We included 174 studies reporting on MIA (mean overall prevalence 20.1%, range 2–44.9%) in 134 study populations with 86,989 intracranial aneurysm (IA) patients enrolled between 1950 and 2015. Studies from Europe and North-America (p<0.001) and more recent enrolment years (p=0.046) were independently associated with higher MIA prevalence. In meta-analysis, MIA correlated with female sex (odds ratio [OR]=1.59, 95% CI 1.4–1.8), higher patient age (>40 years; OR=1.6, 1.14–2.25), arterial hypertension (OR=1.51, 1.17–1.94), smoking (OR=1.89, 1.37–2.6) and familiar IA (OR=2.02, 1.47–2.77), and formation of de novo (OR=3.92, 1.95–7.87) and growth of initial IA (OR=3.47, 1.87–6.45). Risk of subarachnoid hemorrhage in MIA patients was higher only in longitudinal studies from Japan and Korea (OR=2.08, 1.46–2.96).

Conclusion: Female sex, higher age, arterial hypertension, smoking and familiar IA are major risk factors for MIA. In addition, MIA patients are at risk for enhanced IA formation. Further studies are needed to evaluate rupture risk and the role of ethnicity, especially in the context of increased MIA identification with improved neurovascular imaging.