Pattern of Cerebral Aneurysms in a Kenyan Population as Seen at an Urban Hospital

Nabaweesi-Batuka, Jennifer; Kitunguu, Peter; Kiboi, Julius G.

doi:10.1016/j.wneu.2015.09.061

Cited by 13 publications

(14 citation statements)

References 43 publications

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“…The average AR size in our population was smaller than that reported in previous studies (2.5 to 5 mm CI 95% 1.3 SD). These findings are in disagreement with previous studies such as that by Nabaweesii et al., 26 who reported ARs of 1–27 mm, with an average size of 7–8 mm, but are supported by others, such as the Cooperative Aneurysm Study, which reported that 20% of ruptured aneurysms were <5 mm 27 . A literature review was performed (Table 5).…”

Section: Discussionmentioning

confidence: 55%

Aneurysmal Subarachnoid Hemorrhage Associated with Small Aneurysms in Smokers and Women: A Retrospective Analysis

Figueredo

Pedraza‐Ciro

Lopez-McCormick

et al. 2019

World Neurosurgery: X

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Background Previous studies have shown low rupture rates for small aneurysms (<10 mm), suggesting that the risk of treatment could exceed the benefits. However, evidence has changed, showing crescent rates of aneurysmal subarachnoid hemorrhage (aSAH) associated with small aneurysms. We report trends in size, localization, clinical characteristics, and outcomes of intracranial aneurysms (IAs). Methods In this retrospective study, a total of 200 clinical histories of patients diagnosed with IAs over an 8-year period were analyzed. Variables considered included age, sex, tobacco consumption, morphological characteristics of the aneurysm, complications, vasospasm, and mortality. Qualitative variables were assessed by measurements of absolute and relative frequency. Smoking behavior, aneurysm size, and aneurysm rupture (AR) were compared using 1-way analysis of variance. Categorical variables were analyzed using Pearson's χ 2 test. Results The average age at presentation was 58 years. The average size of ruptured aneurysms in the general group was 2.5–7.5 mm, and AR was most common in women (76%) and in patients age 50–60 years (33%). The rate of vasospasm was 19%, and mortality was 37%. Smokers composed 32% of the cohort. Heavy smokers had a 57% rate of aSAH, with an average size of rupture of 5 mm. The most common location of aneurysms and AR was the AComA (33%). Conclusions Our results suggest increasing AR rates in aneurysms smaller than 10 mm. This trend is seen especially in individuals with heavy tobacco consumption and in women of perimenopausal age. Our findings show a tendency of AR in accordance with previous results and are expected to serve as basis for further research on aneurysm management.

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Section: Discussionmentioning

confidence: 55%

Aneurysmal Subarachnoid Hemorrhage Associated with Small Aneurysms in Smokers and Women: A Retrospective Analysis

Figueredo

Pedraza‐Ciro

Lopez-McCormick

et al. 2019

World Neurosurgery: X

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“…The production of estrogen dramatically declines with menopause, which has been postulated to explain the increased development of cerebral aneurysms in women after their fourth and fifth decades of life. 17,21 Murine models support this theory and have demonstrated increased intracranial aneurysm development with the loss of estrogen by ovariectomy and the restoration of its protective affect after the administration of estrogen agonists. 5 However, the study of estrogens and aSAH is more complex and insufficient in humans.…”

Section: Discussionmentioning

confidence: 88%

Association of Reproductive Life Span and Age at Menopause With the Risk of Aneurysmal Subarachnoid Hemorrhage

Lai

Jiménez

2022

Neurology

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Background and Objectives:Subarachnoid hemorrhage from cerebral aneurysm remains a devastating disease with high mortality and morbidity. Cerebral aneurysm and its rupture are more prevalent in post-menopausal women and have been postulated to be hormonally influenced. The goal of this study was to investigate the associations of female-specific factors, including reproductive life span, age at menarche, and age at menopause, with the incidence of aneurysmal subarachnoid hemorrhage (aSAH) in women.Methods:Participants in the Nurses’ Health Study were followed from 1980 or the time of reaching menopause until 2018, Only women with natural menopause or surgical menopause due to bilateral oophorectomy were included. Reproductive life span was defined by subtracting the age at menarche from the age at menopause. Multivariable stratified proportional hazards models were used to study reproductive life span, age at menarche and age at menopause with the incidence of aSAH. Multivariable models were adjusted for age, race, smoking, hysterectomy, hypertension, hyperlipidemia, body mass index, hormone therapy use, oral contraceptive use, and parity.Results:A total of 97,398 postmenopausal women with reproductive lifespan data were included, with 138 participants developed aneurysmal subarachnoid hemorrhage which was confirmed on medical record review by a physician. A shorter reproductive lifespan (≤35 years) was associated with a two-fold higher incidence of aSAH after multivariable adjustment (HR=2.0 [95%CI 1.4-2.8]). Early age at menopause (age<45) was similarly associated with a higher risk of aSAH (HR=2.1 [95%CI 1.4-3.1]), but age at menarche was not. The use of oral contraceptives and postmenopausal hormone therapy were not associated with the incidence of aSAH.Discussion:An earlier age at menopause, as well as a shorter reproductive life span duration (≤35 years), were associated with a higher risk of incident aSAH in women. No associations were noted for age at menarche, parity, oral contraceptive use or postmenopausal therapy use.

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“…Saccular aneurysms were found in half of the patients making them the most common aneurysms similar to reports from other parts of the world. [ 11 12 ] ACOM aneurysms and MCA aneurysms were the most common aneurysms among cohorts [ Table 1 ]. Beck et al .…”

Section: Discussionmentioning

confidence: 99%

Predictors of outcome following interventions for ruptured intracranial aneurysms in an emerging health institution in West Bengal: A 6-year experience

et al. 2021

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Background: Microsurgical clipping and endovascular coiling have remained over the past half-century, the main options for definitive treatment of ruptured intracranial aneurysms. However, recent advances in endovascular techniques have broadened their application stimulating much debate regarding the usefulness of microsurgical options. For locations with limited capacity or evolving endovascular service, however, microsurgical treatment offers not only cost-effective and durable options but also oftentimes the only option available for most patients. Materials and Methods: This was a single institution questionnaire-based retrospective study from West Bengal India. It was performed on patients with aneurysmal rupture managed from June 2010 to October 2016. Data analysis was performed with SPSS for Windows, version 21. Results: One hundred and ten patients were studied. The mean age was 50.8 years (standard deviation [SD] ±13.5) for females and 50.2 (SD ± 12.4) for males ( P = 0.8112, t -test). Ninety (81.8%) patients received microsurgical clipping. Microsurgical options such as wrapping, bypass, and excision were performed for 9 (8.2%) patients. Coiling was performed for 11 (10%) patients. ACOM was the most common site for ruptured aneurysm. Ictus-intervention interval (χ 2 = 10.034, P = 0.007) and multiple surgical procedures (χ 2 = 8.9341, P = 0.003) were the significant outcome determinants. Overall, 72.7% of those treated had a good outcome (Glasgow Outcome Score of 4 and 5). The good outcome was higher among microsurgery groups (73.7%) compared to the coiling group (63.6%) but this difference did not achieve statistical significance (χ 2 = 0.46 P = 0.4976). Conclusion: Microsurgical options achieved good outcomes in the management of ruptured aneurysms in our series. Their availability makes them first-line options for low-income settings.

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Pattern of Cerebral Aneurysms in a Kenyan Population as Seen at an Urban Hospital

Cited by 13 publications

References 43 publications

Aneurysmal Subarachnoid Hemorrhage Associated with Small Aneurysms in Smokers and Women: A Retrospective Analysis

Aneurysmal Subarachnoid Hemorrhage Associated with Small Aneurysms in Smokers and Women: A Retrospective Analysis

Association of Reproductive Life Span and Age at Menopause With the Risk of Aneurysmal Subarachnoid Hemorrhage

Predictors of outcome following interventions for ruptured intracranial aneurysms in an emerging health institution in West Bengal: A 6-year experience

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