Prevalence of incidental brain aneurysms between men and women

Keywords: Cerebral Hemorrhage, Intracranial Aneurysm, Stroke

Abstract

Verifying the prevalence of incidental cerebral aneurysm diagnosed by magnetic resonance imaging (MRI) between men and women. This research is a descriptive retrospective, database-based cohort study. The sample is composed of 1,545 patients. We use cross-tabulations to perform the absolute and relative frequencies. The Mann-Whitney U-Test was used to compare results between sexes. Incidental aneurysms have a higher relative frequency in women. The age of the highest incidence is 51 to 60 years for both genders. The risk factors present in both sexes are hypertension, dyslipidemia, smoking, diabetes, and polycystic kidneys. The women present a higher incidence of aneurysms in the posterior communicating arteries and internal carotid artery. For the men, there is a higher incidence of aneurysms in the anterior communicating arteries and the basilar artery. Modifiable risk factors are mostly responsible for the growth and development of aneurysms. In sum, the prevalence of incidental cerebral aneurysms in women occurs in a 3: 1 ratio to men, but this prevalence ranged from 2:1 to 9:1 among the years surveyed.

Author Biographies

Jarbas Galvao, Universidade Regional de Blumenau - FURB
Master´s Degree in Regional Development (FURB); Professor of the Department of Nursing at the Universidade Regional de Blumenau (FURB), Blumenau SC Brazil.
Daniela Delwing de Lima, Universidade da Região de Joinville - UNIVILLE
Doctor´s degree in Biological Sciences (Biochemistry) by the Universidade Federal do Rio Grande do Sul (UFRGS); Professor in the Postgraduate Program in Health and Environment at Universidade da Região de Joinville (UNIVILLE), Joinville SC Brazil
Leandro José Haas, Universidade Regional de Blumenau - FURB
Specialist in Interventionist Neuro-radiology (Foundation Rothschild); Interventionist Neuro-radiology (David Geffen School of Medicine, University of California, Los Angeles); Professor of the Department of Medicine at the Universidade Regional de Blumenau (FURB), Bluemenau SC Brazil.

References

Chalouhi N, Ali MS, Jabbour PM, Tjoumakaris SI, Gonzales LF, Rosenwasser RH, Koch WJ, Dumont AS. Biology of intracranial aneurysms: role of inflammation. J Cereb Blood Flow Metab. 2012; 32 (9):1659–1976.

Revilla-Pacheco F, Escalante-Seyffert MC, Herrada-Pineda T, Manrique-Guzman S, Perez-Zuniga I, Rangel-Suarez S, et al. Prevalence of Incidental Clinoid Segment Saccular Aneurysms. World Neurosurg. 2018; 115:244-251.

García PLR, García DR. Hemorragia subaracnoidea: epidemiologia, etiologia, fisiopatologia y diagnóstico. Revista Cubana de neurologia y neurocirocirugía. 2011; 1(1):59-73.

Mayer SA, Kreiter KT, Copeland D. Bernardini GL, Bates JE, Peery S, et al. Comprometimento cognitivo global e de domínio específico e desfecho após hemorragia subaracnóidea. Neurology; 2002; 59:1750.

Malhotra A, Wu X, Gandhi D, Sanelli P. The Patient with Thunderclap Headache. Neuroimaging Clin N Am. 2018; 28(3): 335-351.

Vlak M H, et al. Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis. Lancet Neurol. 2011;10 (7): 626-36.

Bonilha L, Marques LE, Carelli FE, Fernandes YB, Cardoso AC, Maldaum MVM, Borges G. Risk Factors and Outcome in 100 patients with aneurysmal subarachnoid hemorrhage. Arq Neuropsiquiatr. 2001; 59 (3): 676-80.

Toth G, Cerejo R. Intracranial aneurysms: Review of current science and management. Vasc Med. 2018; 23 (3): 276-288.

Williams LN, Junior RDB. Management of unruptured intracranial aneurysms. Neurology clinical practice.2013;(2): 99-108.

Brisman JL, Song JK, Newell, DW. Cerebral aneurysms. N Engl J Med. 2006; 355 (9):928-39.

Yoon W. Current update on the randomized controlled trials of intracranial aneurysms. Neurointervention. 2011; 6:1–5.

Feigin VL, Rinkel GJ, Lawes CM, Algra A, Bennett DA, Van Gijn J, Anderson CS. Risk factors for subarachnoid hemorrhage: an updated systematic review of epidemiological studies. Stroke. 2005; 36:2773–2780.

Turcato C, Pereira SW, Ghizoni, MF. Hemorragia Subaracnóidea. Arquivos Catarinenses de Medicina. 2006;35 (2):78-84.

Melo-Souza SE. Tratamento das Doenças Neurológicas. 2.ed. Rio de Janeiro: Guanabara Koogan. 2008.142p.

Júnior AT, Batista MHO, Souza RM, Pereira LS, Siqueira MCP. Estudo Retrospectivo: Prevalência de Aneurismas Cerebrais por Topografia Vascular no Hospital Evangélico Goiano. Revista Brasileira de Neurologia e Psiquiatria. 2014; 18(3): 209-223.

Ghods A.J, Lopes D, Chen M. Gender differences in cerebral aneurysm location. Frontiers in neurology. 2012; 3:78.

Imaizumi Y, Mizutani T, Shimizu K, Sato Y, Taguchi J. Detection rates and sites of unruptured intracranial aneurysms according to sex and age: an analysis of MR angiography-based brain examinations of 4070 healthy Japanese adults. J Neurosurg. 2018; p.1-6.

Ito H, Kawaminami T, Asano K, Fukubaga T, Karai C, Okuma S, et al. The Prevalence of Unruptured Cerebral Aneurysms in Okinoerabu: A Japanese Hospital-Based Study. J Neurol Neurosci. 2018; 9 (5): 273.

Morita A, Kirino T, Hashi K, Aoki N, Fukuhara S, Hashimoto N, et al. The natural course of unruptured cerebral aneurysms in a Japanese cohort. N Engl J Med. 2012;366 (26):2474–2482.

Lindekleiv HM, Valen SK, Morgam MK, Mardal KA, Fauder K, Magnus JH, et al. Sex differences in intracranial arterial bifurcations. Gend Med. 2010; 7 (2):149–155.

Horikoshi T, Akiyama L,Yamagata Z, Sugita H, Nukui H. Magnetic resonance angiographic evidence of sex-linked variations in the circle of Willis and the occurrence of cerebral aneurysms. J Neurosurg. 2002; 96 (4):697–703.

Ingebrigtsen T, Faulder K, Ingebrigtsen L, Morgan M. Bifurcation geometry and the presence of cerebral artery aneurysms. J Neurosurgery. 2004,101 (1):108-113.

Mhurchu CN, Anderson C, Jamrozi k, Hankey G, Dunbabin D. Australasian Cooperative Research on Subarachnoid Hemorrhage Study (ACROSS) Group. Hormonal factors and risk of aneurysmal subarachnoid hemorrhage: an international population-based, case-control study. Stroke. 2001;32 (3):606–612.

Tada Y, Zhang L, Zhao L, Liu H, Zeng J X, Yang J, et al. Roles of estrogen in the formation of intracranial aneurysms in ovariectomized female mice. Neurosurgery. 2014; 75 (6):690-695.

Park S et al. Invasive Sacral Aneurysms in Angioresonance: 5 years of experience in a single large volume center. J Stroke.v.16, n.3, p.189-94,2014.

Hamdan A, Barnes J, Mitchell P. Subarachnoid hemorrhage and the female sex: analysis of risk factors, aneurysm characteristics, and outcomes. Journal of Neurosurgery. 2014;121 (6):1367–1373.

Lindgren AE, Kuriki MI, Riihinen A, Koivisto T, Ronkainen U, Rinne J. Hypertension predisposes to the formation of saccular intracranial aneurysms in 467 unbroken and 1053 ruptured patients in eastern Finland. Ann Med. 2014;46 (3):169-176.

Winn HR, Jane JA, Taylor J, Kaiser D, Britz GW. Prevalence of asymptomatic incidental aneurysms: review of 4568 arteriograms. J Neurosurg. 2002; 96(1): 43-49.

Rinkel GJ, Djibuti H, Algra A, Yan GJ. Prevalence and risk of rupture of intracranial aneurysms: a systematic review. Stroke. 1998, 29(1): 251-256.

Harada K , Fukuyama K, Shirouzu T, Fulimura H, Kakumoto K, Yamanaga T, et al. Prevalence of unruptured intracranial aneurysms in asymptomatic healthy Japanese adults: differences in gender and age. Acta Neurochir. 2013; 155 (11): 2037-2043.

Published
2020-06-12
Section
Artigos Originais