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  • Author or Editor: Neil D. Kitchen x
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Habib E. Ellamushi, Joan P. Grieve, H. Rolf Jäger and Neil D. Kitchen

Object. Several factors are known to increase the risk of subarachnoid hemorrhage (SAH) and spontaneous intracerebral hematoma. However, information on the roles of these same factors in the formation of multiple aneurysms is less well defined. The purpose of this study was to examine factors associated with an increased risk of multiple aneurysm formation.

Methods. A retrospective review of the medical records of all patients with a diagnosis of SAH and intracranial aneurysms who were admitted to a single institution between 1985 and 1997 was undertaken. The authors examined associations between risk factors (patient age and sex, menopausal state of female patients, hypertension, cigarette smoking, alcohol consumption, history of cardiovascular disease or diabetes mellitus, and family history of cerebrovascular disease) and the presence of multiple aneurysms by using the Fisher exact test and logistic regression analysis. Of 400 patients admitted with a diagnosis of cerebral aneurysms, 392 were included in the study (287 women and 105 men). Two hundred eighty-four patients harbored a single aneurysm and 108 harbored multiple aneurysms (2 aneurysms in 68 patients, three aneurysms in 22 patients, four aneurysms in 13 patients, and five aneurysms in five patients).

Conclusions. Statistical analysis revealed that, as opposed to the occurrence of a single aneurysm, there was a significant association between the presence of multiple aneurysms and hypertension (p < 0.001), cigarette smoking (p < 0.001), family history of cerebrovascular disease (p < 0.001), female sex (p < 0.001), and postmenopausal state in female patients (p < 0.001).

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Ahmed K. Toma, Andrew Tarnaris, Joan P. Grieve, Laurence D. Watkins and Neil D. Kitchen


In this paper, the authors' goal was to compare the artifact induced by implanted (in vivo) adjustable shunt valves in spin echo, diffusion weighted (DW), and gradient echo MR imaging pulse sequences.


The MR images obtained in 8 patients with proGAV and 6 patients with Strata II adjustable shunt valves were assessed for artifact areas in different planes as well as the total volume for different pulse sequences.


Artifacts induced by the Strata II valve were significantly larger than those induced by proGAV valve in spin echo MR imaging pulse sequence (29,761 vs 2450 mm3 on T2-weighted fast spin echo, p = 0.003) and DW images (100,138 vs 38,955 mm3, p = 0.025). Artifacts were more marked on DW MR images than on spin echo pulse sequencse for both valve types.


Adjustable valve–induced artifacts can conceal brain pathology on MR images. This should influence the choice of valve implantation site and the type of valve used. The effect of artifacts on DW images should be highlighted pending the development of less MR imaging artifact–inducing adjustable shunt valves.