Ethnic characteristics of location for cerebral aneurysms
https://doi.org/10.14412/2074-2711-2019-2-60-64
Abstract
Objective: to establish the characteristics of location for cerebral aneurysms according to ethnicity in the population of Yakutia.
Patients and methods. A total of 433 patients with aneurysmal hemorrhagic stroke (AHS) who had been admitted consecutively to the regional vascular center (Yakutsk) were examined. Group 1 included representatives of the indigenous ethnic groups of the Asian race in Yakutia (n=331; 33.8% of men); Group 2 comprised patients of the Caucasian race (n=102; 45.1% of men). The diagnosis was made by digital subtraction cerebral angiography (77.6%) and multislice computed tomography angiography (22.4%).
Results. A total of 433 ruptured saccular aneurysms, including the latter in the anterior cerebral and anterior communicating arteries (ACAAcoA) (33.8%), middle cerebral artery (MCA) (38.7%), internal carotid artery (ICA) (21.6%), and vertebrobasilar arteries (5.8%), were diagnosed. In Group 1, the most common location for aneurysms was MCA (41.1 and 39.7% in men and women, respectively); in Group 2, that was ACA-AcoA (52.2%) in men and ICA (42.8%) in women. The ethnic groups showed significant differences in the incidence of MCA aneurysms (40.2 and 26.4% in Groups 1 and 2; respectively (p=0.014)); (odds ratio (OR = 1.866; 95% confidence interval (CI), 1.111–3.146). In Group 1, the incidence of MCA aneurysms was higher in women than in those in Group 2 (p=0.012) (OR=2.417; 95% CI, 1.155–5.141).
Conclusion. The location for cerebral aneurysms differs according to ethnicity. In Yakutia among AHS patients, the most frequent location for aneurysms is MCA among indigenous Asians, while that is ACA-AcoA in Caucasian men and ICA is in Caucasian women. The incidence of MCA aneurysms is significantly higher in indigenous Asian women than in Caucasian ones.
About the Author
S. A. Chugunova
Medical Institute, M.K. Ammosov North-Eastern Federal University
Russian Federation
Russian Federation
Sargylana Afanasyevna Chugunova
27, Oiunsky St., Yakutsk 677000
References
1. Skvortsova VI, Krylov VV, editors. Gemorragicheskii insul't: prakticheskoe rukovodstvo [Hemorrhagic stroke: a practical guide]. Moscow: GEOTAR-Media; 2005. 160 p.
2. Krylov VV, Eliava ShSh, Yakovlev SB, et al. Clinical practice guidelines for the treatment of unruptured asymptomatic aneurysms in the brain. Voprosy neirokhirurgii. 2016;(5):124-35. (In Russ.).
3. Caranci F, Briganti F, Cirillo L, et al. Epidemiology and genetics of intracranial aneurysms. Eur J Radiol. 2013 Oct;82(10): 1598-605. doi: 10.1016/j.ejrad.2012.12.026. Epub 2013 Feb 8.
4. De Rooij NK, Linn FH, van der Plas JA, et al. Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends. J Neurol Neurosurg Psychiatry. 2007 Dec;78(12):1365-72. Epub 2007 Apr 30.
5. Eden SV, Meurer WJ, Sanchez BN, et al. Gender and ethnic differences in subarachnoid hemorrhage. Neurology. 2008 Sep 2;71(10): 731-5. doi: 10.1212/01.wnl.0000319690.82357.44. Epub 2008 Jun 11.
6. Labovitz DL, Halim AX, Brent B, et al. Subarachnoid hemorrhage incidence among Whites, Blacks and Caribbean Hispanics: the Northern Manhattan Study. Neuroepidemiology. 2006;26(3):147-50. Epub 2006 Feb 21.
7. Kontogorov II, Vasil'eva NA, Larionov PI, et al. Epidemiological characteristics and results of surgical treatment of subarachnoid hemorrhages of aneurysmal etiology. Yakutskii meditsinskii zhurnal. 2012;(4):100-1. (In Russ.).
8. Chugunova SA, Nikolaeva TY, Semenov A. Contribution of cerebral vascular anomalies in hemorrhagic stroke structure in different racial groups of Yakutia. Wiad Lek. 2015;68(4):604-7.
9. Korja M, Kivisaari R, Rezai Jahromi B, Lehto H. Size and location of ruptured intracranial aneurysms: consecutive series of 1993 hospital-admitted patients. J Neurosurg. 2017 Oct;127(4):748-753. doi: 10.3171/2016.9.JNS161085. Epub 2016 Dec 2.
10. Weir B, Disney L, Karrison T. Sizes of ruptured and unruptured aneurysms in relation to their sites and the ages of patients. J Neurosurg. 2002 Jan;96(1):64-70.
11. Froelich JJ, Neilson S, Peters-Wilke J, et al. Size and Location of Ruptured Intracranial Aneurysms: A 5-Year Clinical Survey. World Neurosurg. 2016 Jul;91:260-5. doi: 10.1016/j.wneu.2016.04.044. Epub 2016 Apr 20.
12. Gonchar AA, Gonchar IA. Localization of ruptured aneurysms according to cerebral angiography. Meditsinskii zhurnal. 2006;(3):41-3. (In Russ.).
13. Lai HP, Cheng KM, Yu SC, et al. Size, location, and multiplicity of ruptured intracranial aneurysms in the Hong Kong Chinese population with subarachnoid haemorrhage. Hong Kong Med J. 2009 Aug;15(4):262-6.
14. Osawa M, Hongo K, Tanaka Y, et al. Results of direct surgery for aneurysmal subarachnoid haemorrhage: outcome of 2055 patients who underwent direct aneurysm surgery and profile of ruptured intracranial aneurysms. Acta Neurochir (Wien). 2001;143(7): 655-63; discussion 663-4.
15. Zheng Y, Zhou B, Wang X, et al. Size, Aspect Ratio and Anatomic Location of Ruptured Intracranial Aneurysms: Consecutive Series of 415 Patients from a Prospective, Multicenter, Observational Study. Cell Transplant. 2018 Dec 4:963689718817227. doi: 10.1177/0963689718817227. [Epub ahead of print].
16. Imaizumi Y, Mizutani T, Shimizu K, et al. Detection rates and sites of unruptured intracranial aneurysms according to sex and age: ananalysis of MR angiography-based brain examinations of 4070 healthy Japanese adults. J Neurosurg. 2018 Apr 6;130(2):573-578. doi: 10.3171/2017.9.JNS171191.
17. Ghods AJ, Lopes D, Chen M. Gender differences in cerebral aneurysm location. Front Neurol. 2012 May 21;3:78. doi: 10.3389/fneur.2012.00078. eCollection 2012.
18. Mhurchu CN, Anderson CS, Jamrozik KD, et al. Hormonal factors and risk of aneurysmal subarachnoid hemorrhage. An international population – based, case – control study. Stroke. 2001 Mar;32(3):606-12.
19. Alfano JM, Kolega J, Natarajan SK, et al. Intracranial aneurysms occur more frequently at bifurcation sites that typically experience higher hemodynamic stresses. Neurosurgery. 2013 Sep;73(3):497-505. doi: 10.1227/NEU.0000000000000016.
20. Van 't Hof FN, Kurki M, Kleinloog R, et al. Genetic risk load according to the site of intracranial aneurysms. Neurology. 2014 Jul 1; 83(1):34-9. doi: 10.1212/WNL.0000000000000547. Epub 2014 May 30.
Review
For citations:
Chugunova SA. Ethnic characteristics of location for cerebral aneurysms. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2019;11(2):60-64. (In Russ.) https://doi.org/10.14412/2074-2711-2019-2-60-64
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