Microsurgery of Cerebral Aneurysm: Epidemiological Profile

Abstract

Objectives Intracranial aneurysm consists of localized dilatation of the vascular wall. Its importance includes the fearsome event of rupture and subarachnoid hemorrhage, which presents high morbimortality rates. The present study aimed to analyze the profile and clinical outcome of patients submitted to the microsurgical approach of cerebral aneurysm in the city of Criciúma, state of Santa Catarina, Brazil, from 2015 to 2018. Methods A retrospective observational study was performed, with secondary data collection and a quantitative approach of 47 charts. Results A predominance of females (74.5%) and a mean age of 53 years old (53.53 ± 9.64) was observed. The middle cerebral artery was the most affected vessel (36.2%), with the highest percentage of aneurysms being between 2.1 mm and 7.0 mm (65.9%). There was a correlation between consciousness level and classification on the Hunt-Hess (HH) scale. Patients with Glasgow Coma Scale (GCS) > 7 points had a better prognostic score in the HH scale, and those with GCS ≤ 7 points had a worse prognostic score in the HH scale. Conclusions The present study observed the presence of important risk factors for cerebral aneurysm formation, such as gender, age, smoking, and systemic arterial hypertension. The present study can measure a correlation of the level of consciousness with the HH classification.

What Are the Predictors of Intracranial Aneurysm Rupture in Indonesian Population Based on Angiographic Findings? Insight from Intracranial Aneurysm Registry on Three Comprehensive Stroke Centres in Indonesia

“…Most of the subjects with IA in this study are female. This finding is similar with previous studies where females have significantly higher IA prevalence compared with males [18][19][20]. One hypothesis stated that hormonal factors might have a significant role in vessel wall remodelling after menopause [21,22].…”

Internações hospitalares para tratamento de aneurismas cerebrais rotos e não rotos no Sistema Único de Saúde do Brasil, 2009-2018: um estudo descritivo

“…Em concordância com outros estudos, os maiores percentuais de internação por AVC foram registrados na população das faixas etárias entre 40 e 79 anos, independentemente do tipo de procedimento adotado, com destaque para a maior ocorrência de hospitalizações na população do sexo feminino. [11][12][13][14][15] Ser do sexo feminino, encontrar-se nas idades acima de 40 anos, praticar tabagismo, usar álcool, usar drogas e apresentar doenças crônicas (fatores não analisados neste estudo) compõem um conjunto de fatores de risco definidores do perfil da população acometida pela hemorragia subaracnóidea proveniente dos aneurismas cerebrais rotos e aneurismas cerebrais não rotos. 16,17 A literatura, apoiada em diversos estudos, sugere a hipótese de que o declínio dos níveis hormonais após a menopausa provoca estresse hemodinâmico e remodelação vascular nas mulheres, favorecendo a formação dos aneurismas cerebrais, o que, por sua vez, explicaria o predomínio da representatividade do sexo feminino nessas pesquisas.…”

“…16,17 A literatura, apoiada em diversos estudos, sugere a hipótese de que o declínio dos níveis hormonais após a menopausa provoca estresse hemodinâmico e remodelação vascular nas mulheres, favorecendo a formação dos aneurismas cerebrais, o que, por sua vez, explicaria o predomínio da representatividade do sexo feminino nessas pesquisas. 11,12 Outros autores acrescentam a essa explicação o fato de as mulheres terem seu risco aumentado para vasoespasmo. 13 A análise em tela evidenciou o predomínio de hospitalizações por hemorragia subaracnóidea decorrente da ruptura de aneurismas cerebrais, reconhecida como uma urgência neurológica grave, pois resulta do potencial de ruptura dos aneurismas cerebrais presentes na população de forma silenciosa.…”

“…The literature, supported by several studies, suggests the hypothesis that the decline in hormone levels after menopause causes hemodynamic stress and vascular remodeling in women, favoring cerebral aneurysm formation, which, in turn, would explain the prevalence of female representativeness in these studies. 11 , 12 Other authors add to this explanation the fact that women have an increased risk for vasospasm. 13 On-screen analysis showed the prevalence of hospitalizations for subarachnoid hemorrhage due to cerebral aneurysm rupture, recognized as an acute neurological emergency, as it results from the potential of cerebral aneurysm rupture present in the population in a silent way.…”