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  • Title: Impact of aneurysm location on hemorrhage risk.
    Author: Gross BA, Lai PM, Du R.
    Journal: Clin Neurol Neurosurg; 2014 Aug; 123():78-82. PubMed ID: 25012017.
    Abstract:
    INTRODUCTION: Recent studies have reinforced anterior communicating (AComm) artery location as a significant risk factor for aneurysm rupture in addition to posterior circulation/posterior communicating (PComm) artery location. However, studies stratifying aneurysm location in greater detail are sparse. METHODS: We reviewed the records of 747 consecutive patients with 1013 aneurysms seen at our institution over a 7 year period, noting aneurysm location and rupture status at the time of presentation. RESULTS: High proportions of ruptured aneurysms were seen among frontopolar/pericallosal (59%, OR 3.07, p=0.011), vertebral/posteroinferior cerebellar (PICA; 53%, OR 2.49, p=0.0037), AComm (50%, OR 2.46, p<0.0001), and PComm aneurysms (44%, OR 1.77, p=0.0016). Low proportions of ruptured aneurysms were seen among superior hypophyseal artery (SHA; 6%, OR 0.12, p=0.0001), internal carotid artery (ICA) bifurcation (12%, OR 0.27, p=0.0012), and ophthalmic artery aneurysms (15%, OR 0.33, p=0.0002). The proportion of ruptured PComm aneurysms demonstrated a trend toward being greater than anterior choroidal artery aneurysms (OR 2.14, p=0.09); however the proportion was significantly greater among anterior choroidal artery aneurysms as compared to nonPComm intradural ICA aneurysms (OR 2.78, p=0.03). Notably, the lower rupture rate of SHA aneurysms as compared to ophthalmic artery aneurysms neared statistical significance (OR 0.38, p=0.10). CONCLUSION: Aneurysm location has a significant impact on risk of rupture and should be stratified in greater detail in future studies of aneurysm natural history.
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