Size, Localization and Risk Factors in Ruptured and Unruptured Brain Aneurysms

Abstract

Brain aneurysm is a pathological focal enlargement of an artery in the brain, that is, of the inner muscle layer of the blood vessels. The vessel expands in the form of a balloon from varying degrees, where the wall of the aneurysm can become thin and rupture without warning. Brain aneurysms can form and not rupture. They are often discovered incidentally during the examination of other pathological health conditions. Aim: To assess the incidence of brain aneurysms in relation to sex and age, as well as in relation to localization, size and type, that is, bleeding and non-bleeding brain aneurysms. The study also analyzes risk factors for the occurrence and outcome of brain aneurysms. Material and Methods: In the study, 80 patients with symptoms of brain aneurysm were analyzed, and diagnostic procedures were performed to prove the brain aneurysm and establish an indication for further treatment. Results: Of the analyzed patients, 48 (60%) were women, and 32 (40%) were men. In terms of age, the patients had an average age of 56.1 ± 10.3 (31-84 years). In patients with ruptured and unruptured aneurysms, there was a statistically insignificant difference in the average age between these two groups of patients 55.8 ± 9.5 vs 56.8 ± 12.3 years. Ruptured aneurysms were significantly more often diagnosed in male patients 84.38% vs 62.5% in the female population. A statistically significant difference was detected in the distribution of small, large, and giant aneurysms between the groups of ruptured and unruptured aneurysms, where it was shown that small aneurysms were insignificantly more often bleeding 77.19% vs 56.52%, large aneurysms were insignificantly more often non-bleeding 26.09% vs 21.05%, giant aneurysms were significantly more often non-bleeding 17.39% vs 1.75%. Aneurysms were non- bleeding, that is, unruptured in 28.75%, bleeding, that is, ruptured aneurysms were diagnosed in 71.25% of patients. Risk factors were present in 69 (86.25%) patients, of which the most common risk factor was hypertension, which was present in 86.25% of the patients. Hyperlipidemia was present in 33.75% of patients, while diabetes was diagnosed in 13.75%. The risk factor of smoking was present in all patients. Conclusion: Timely diagnosis of brain aneurysms is important in determining the type of aneurysm, its localization, size, and the risk of rupture. Given that non-ruptured diagnosed aneurysms carry a high risk of rupture, the establishment of an indication for endovascular treatment is of particular importance. Control of risk factors, especially smoking and hypertension, is an important segment in the prevention of the occurrence and outcome of brain aneurysms.