Single Center Retrospective Analysis of Cerebral Aneurysms from a Patient Sample Data Collection at a Comprehensive Stroke Center.

Aneurysmal rupture Cerebral aneurysm Fisher Hunt and Hess Spontaneous subarachnoid hemorrhage

Journal

Spartan medical research journal
ISSN: 2474-7629
Titre abrégé: Spartan Med Res J
Pays: United States
ID NLM: 101739886

Informations de publication

Date de publication:
2022
Historique:
received: 18 02 2022
accepted: 11 04 2022
entrez: 21 9 2022
pubmed: 22 9 2022
medline: 22 9 2022
Statut: epublish

Résumé

Institutional self-monitoring of cerebral aneurysm data should occur regularly. The objective of this retrospective single center study was to examine the reproducibility of a data collection and analytic method to examine cerebral aneurysm characteristics and trends. A single center retrospective analysis was performed from 2018 to 2021 of the most recent 100 patient presentations with a newly diagnosed cerebral aneurysm. Data collection included patient demographics, radiographic features, ruptured or unruptured status, location, grading scale, treatment strategy, survival, and length of stay, which were extracted and presented in tabular form and analyzed for overall trends. Of the collected 100 patients meeting ICD-10 criteria, 10 (10%) patients were excluded due to having been previously diagnosed at the institution and not meeting the criteria of a new discovery of cerebral aneurysm for inclusion. The remaining 90 sample patients presented with newly diagnosed aneurysms to the authors' Emergency Department between 2018 and 2021. Most patients were between the ages of 25 and 65 with 55 (61%) patients identifying themselves as female sex. Of the 90 eligible sample patients, 59 (66%) had aneurysms that were not ruptured. Eighty-eight (97.7%) patients had cerebral aneurysms that were < 7mm in size. The most common location for aneurysms was in the anterior cerebral circulation, with identification of 27 middle cerebral artery aneurysms. Length of stay (LOS) ranged from 0-171 days with a mean of 11.97 days (SD = 19.9). Of the seven (7.7%) patients who expired, four (57%) experienced spontaneous subarachnoid hemorrhages, with two (29%) occurring in the anterior communicating artery and one (14%) in the left middle cerebral artery and basilar artery respectively. The typical presentation of a cerebral aneurysm is unruptured with a pre-dominance in middle-aged females. Our findings are congruent with the literature regarding the location of the aneurysm originating in the anterior circulation. However, most aneurysms in our clinical cohort were located on the MCA/ICA in contrast to the literature reported (i.e., most anterior communicating artery). Of those patients who presented unruptured, outpatient follow-up and routine monitoring were appropriate with medical management in the setting of small aneurysms. The risk of progression and subsequent rupture was relatively small in this patient cohort. Multi-year examinations of single institution comprehensive stroke centers regarding cerebral aneurysms would enable researchers to conduct regional analyses and comparisons to national and international trends.

Identifiants

pubmed: 36128026
pii: 34494
pmc: PMC9448660

Types de publication

Journal Article

Langues

eng

Pagination

34494

Références

Stroke. 1996 Apr;27(4):625-9
pubmed: 8614919
Stroke. 2014 Jul;45(7):1958-63
pubmed: 24851875
J Neurol Neurosurg Psychiatry. 2007 Dec;78(12):1365-72
pubmed: 17470467
Interv Neurol. 2018 Feb;7(1-2):53-64
pubmed: 29628946
Stroke. 2008 Mar;39(3):1049-55
pubmed: 18258833
Stroke. 1998 Jan;29(1):251-6
pubmed: 9445359
Neurosurg Focus. 2018 May;44(5):E4
pubmed: 29712518
Stroke. 2011 Jun;42(6):1730-5
pubmed: 21493902
Front Neurol. 2012 May 21;3:78
pubmed: 22661965
N Engl J Med. 1998 Dec 10;339(24):1725-33
pubmed: 9867550
J Neurointerv Surg. 2018 Jul;10(Suppl 1):i69-i76
pubmed: 30037962
Eur J Radiol. 2013 Oct;82(10):1598-605
pubmed: 23399038
Interv Neurol. 2015 Jul;3(3-4):174-83
pubmed: 26279664
Mcgill J Med. 2006 Jul;9(2):141-6
pubmed: 18523626
Ann Biomed Eng. 2013 Jul;41(7):1347-65
pubmed: 23549899
Lancet. 2003 Jul 12;362(9378):103-10
pubmed: 12867109
J Neurosurg. 1968 Jan;28(1):14-20
pubmed: 5635959
N Engl J Med. 1992 Mar 12;326(11):733-6
pubmed: 1738378
Stroke. 2005 Dec;36(12):2773-80
pubmed: 16282541
Stroke. 2001 Sep;32(9):2012-20
pubmed: 11546890
Semin Neurol. 2010 Nov;30(5):537-44
pubmed: 21207346
J Clin Neurosci. 2018 Feb;48:181-184
pubmed: 29100674
Case Rep Neurol Med. 2018 Oct 4;2018:1879329
pubmed: 30402309
Neuroradiology. 2019 Mar;61(3):275-284
pubmed: 30456458
Neuroradiology. 2021 Sep;63(9):1511-1519
pubmed: 33625550
Neurology. 1958 Jan;8(1):41-4
pubmed: 13493689

Auteurs

Brian Fiani (B)

Department of Neurosurgery, Weill Cornell Medical Center/New York Presbyterian Hospital, New York, NY.

Frank DeStefano (F)

College of Osteopathic Medicine, Kansas City University, Kansas City, MO.

Alessandra Cathel (A)

Department of Neurosurgery, Desert Regional Medical Center, Palm Springs, CA.

Marisol Soula (M)

Grossman School of Medicine, New York University, New York, NY.

Taylor K Reardon (TK)

Kentucky College of Osteopathic Medicine, University of Pikeville, Pikeville, KY.

Classifications MeSH