This site uses cookies, tags, and tracking settings to store information that help give you the very best browsing experience. Dismiss this warning

Risk factors for the formation of multiple intracranial aneurysms

Habib E. Ellamushi Department of Surgical Neurology, The National Hospital For Neurology and Neurosurgery, Queen Square, London, United Kingdom

Search for other papers by Habib E. Ellamushi in
Current site
Google Scholar
PubMed
Close
 F.R.C.S.
,
Joan P. Grieve Department of Surgical Neurology, The National Hospital For Neurology and Neurosurgery, Queen Square, London, United Kingdom

Search for other papers by Joan P. Grieve in
Current site
Google Scholar
PubMed
Close
 F.R.C.S.
,
H. Rolf Jäger Department of Surgical Neurology, The National Hospital For Neurology and Neurosurgery, Queen Square, London, United Kingdom

Search for other papers by H. Rolf Jäger in
Current site
Google Scholar
PubMed
Close
 M.D., F.R.C.R.
, and
Neil D. Kitchen Department of Surgical Neurology, The National Hospital For Neurology and Neurosurgery, Queen Square, London, United Kingdom

Search for other papers by Neil D. Kitchen in
Current site
Google Scholar
PubMed
Close
 M.D., F.R.C.S.(SN)
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $536.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $636.00
USD  $45.00
USD  $536.00
USD  $636.00
Print or Print + Online Sign in

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).

  • Collapse
  • Expand
  • 1.

    Andrews RJ: Intracranial aneurysms: characteristic of aneurysms in siblings. N Engl J Med 297:115, 1977 (Letter) Andrews RJ: Intracranial aneurysms: characteristic of aneurysms in siblings. N Engl J Med 297:115, 1977 (Letter)

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Andrews RJ, & Spiegel PK: Intracranial aneurysms. Age, sex, blood pressure, and multiplicity in an unselected series of patients. J Neurosurg 51:2732, 1979 Andrews RJ, Spiegel PK: Intracranial aneurysms. Age, sex, blood pressure, and multiplicity in an unselected series of patients. J Neurosurg 51:27–32, 1979

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Campos C, , Churojana A, & Rodesch G, et al: Multiple intracranial arterial aneurysms: a congenital metameric disease? Intervent Neuroradiol 4:293299, 1998 Campos C, Churojana A, Rodesch G, et al: Multiple intracranial arterial aneurysms: a congenital metameric disease? Intervent Neuroradiol 4:293–299, 1998

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    D'Angelo VA, , Ceddia AM, & Zelante L, et al: Multiple intracranial aneurysms in a patient with Seckel syndrome. Childs Nerv Syst 14:8284, 1998 D'Angelo VA, Ceddia AM, Zelante L, et al: Multiple intracranial aneurysms in a patient with Seckel syndrome. Childs Nerv Syst 14:82–84, 1998

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Gärde A, , Bohmer G, & Seldën B, et al: 100 cases of spontaneous intracerebral haematoma. Diagnosis, treatment and prognosis. Eur Neurol 22:161172, 1983 Gärde A, Bohmer G, Seldën B, et al: 100 cases of spontaneous intracerebral haematoma. Diagnosis, treatment and prognosis. Eur Neurol 22:161–172, 1983

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Handa H, , Hashimoto N, & Nagata I, et al: Saccular cerebral aneurysms in rats: a newly developed animal model of the disease. Stroke 14:857886, 1983 Handa H, Hashimoto N, Nagata I, et al: Saccular cerebral aneurysms in rats: a newly developed animal model of the disease. Stroke 14:857–886, 1983

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Hicks SP, & Black BK: The relation of cardiovascular disease to apoplexy. A review of 155 cases with autopsy. Am Heart J 38:528536, 1949 Hicks SP, Black BK: The relation of cardiovascular disease to apoplexy. A review of 155 cases with autopsy. Am Heart J 38:528–536, 1949

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Inagawa T: Multiple intracranial aneurysms in elderly patients. Acta Neurochir 106:119126, 1990 Inagawa T: Multiple intracranial aneurysms in elderly patients. Acta Neurochir 106:119–126, 1990

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Inagawa T, & Hirano A: Autopsy study of unruptured incidental intracranial aneurysms. Surg Neurol 34:361365, 1990 Inagawa T, Hirano A: Autopsy study of unruptured incidental intracranial aneurysms. Surg Neurol 34:361–365, 1990

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Inagawa T, & Hirano A: Ruptured intracranial aneurysms: an autopsy study of 133 patients. Surg Neurol 33:117123, 1990 Inagawa T, Hirano A: Ruptured intracranial aneurysms: an autopsy study of 133 patients. Surg Neurol 33:117–123, 1990

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    International Study of Unruptured Intracranial Aneurysms Investigators: Factors related to the development and detection of single versus multiple unruptured intracranial aneurysms. Stroke 27:178, 1996 (Abstract) International Study of Unruptured Intracranial Aneurysms Investigators: Factors related to the development and detection of single versus multiple unruptured intracranial aneurysms. Stroke 27:178, 1996 (Abstract)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    International Study of Unruptured Intracranial Aneurysms Investigators: Unruptured intracranial aneurysms—risk of rupture and risks of surgical intervention. N Engl J Med 339:17251733, 1998 International Study of Unruptured Intracranial Aneurysms Investigators: Unruptured intracranial aneurysms—risk of rupture and risks of surgical intervention. N Engl J Med 339:1725–1733, 1998

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Jellinger K: Pathology of intracerebral hemorrhage. Zentralbl Neurochir 38:2942, 1977 Jellinger K: Pathology of intracerebral hemorrhage. Zentralbl Neurochir 38:29–42, 1977

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Juvela S: Prevalence of risk factors in spontaneous intracerebral haemorrhage and aneurysmal subarachnoid haemorrhage. Arch Neurol 53:734740, 1996 Juvela S: Prevalence of risk factors in spontaneous intracerebral haemorrhage and aneurysmal subarachnoid haemorrhage. Arch Neurol 53:734–740, 1996

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Juvela S, , Hillbom M, & Numminen H, et al: Cigarette smoking and alcohol consumption as risk factors for aneurysmal subarachnoid haemorrhage. Stroke 24:639646, 1993 Juvela S, Hillbom M, Numminen H, et al: Cigarette smoking and alcohol consumption as risk factors for aneurysmal subarachnoid haemorrhage. Stroke 24:639–646, 1993

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Knekt P, , Reunanen A, & Aho K, et al: Risk factors for subarachnoid haemorrhage in a longitudinal population study. J Clin Epidemiol 44:933939, 1991 Knekt P, Reunanen A, Aho K, et al: Risk factors for subarachnoid haemorrhage in a longitudinal population study. J Clin Epidemiol 44:933–939, 1991

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Kongable GL, , Lanzino G, & Germanson TP, et al: Gender-related differences in aneurysmal subarachnoid haemorrhage. J Neurosurg 84:4348, 1996 Kongable GL, Lanzino G, Germanson TP, et al: Gender-related differences in aneurysmal subarachnoid haemorrhage. J Neurosurg 84:43–48, 1996

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Lejeune JP: Les anévrismes intracrâniens familiaux. Revue de la litterature. Neurochirurgie 43:292298, 1997 Lejeune JP: Les anévrismes intracrâniens familiaux. Revue de la litterature. Neurochirurgie 43:292–298, 1997

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Longstreth WT Jr, , Nelson LM, & Koepsell TD, et al: Cigarette smoking, alcohol use, and subarachnoid haemorrhage. Stroke 23:12421249, 1992 Longstreth WT Jr, Nelson LM, Koepsell TD, et al: Cigarette smoking, alcohol use, and subarachnoid haemorrhage. Stroke 23:1242–1249, 1992

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    McCormick WF, & Schmalstieg EJ: The relation of arterial hypertension to intracranial aneurysms. Arch Neurol 34:285287, 1977 McCormick WF, Schmalstieg EJ: The relation of arterial hypertension to intracranial aneurysms. Arch Neurol 34:285–287, 1977

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Morris KM, , Shaw MD, & Foy PM: Smoking and subarachnoid haemorrhage: a case control study. Br J Neurosurg 6:429432, 1992 Morris KM, Shaw MD, Foy PM: Smoking and subarachnoid haemorrhage: a case control study. Br J Neurosurg 6:429–432, 1992

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Østergaard JR, & Høg E: Incidence of multiple intracranial aneurysms: influence of arterial hypertension and gender. J Neurosurg 63:4955, 1985 Østergaard JR, Høg E: Incidence of multiple intracranial aneurysms: influence of arterial hypertension and gender. J Neurosurg 63:49–55, 1985

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Petitti DB, & Wingerd J: Use of oral contraceptives, cigarette smoking and risk of subarachnoid haemorrhage. Lancet 2:234235, 1978 Petitti DB, Wingerd J: Use of oral contraceptives, cigarette smoking and risk of subarachnoid haemorrhage. Lancet 2:234–235, 1978

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Qureshi AI, , Suarez JI, & Parekh DP: Risk factors for multiple intracranial aneurysms. Neurosurgery 43:2227, 1998 Qureshi AI, Suarez JI, Parekh DP: Risk factors for multiple intracranial aneurysms. Neurosurgery 43:22–27, 1998

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Rinne J, , Hernesniemi J, & Niskanen M, et al: Management outcome for multiple intracranial aneurysms. Neurosurgery 36:3138, 1995 Rinne J, Hernesniemi J, Niskanen M, et al: Management outcome for multiple intracranial aneurysms. Neurosurgery 36:31–38, 1995

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Rinne J, , Hernesniemi J, & Puranen M, et al: Multiple intracranial aneurysms in a defined population: prospective angiographic and clinical study. Neurosurgery 35:803808, 1994 Rinne J, Hernesniemi J, Puranen M, et al: Multiple intracranial aneurysms in a defined population: prospective angiographic and clinical study. Neurosurgery 35:803–808, 1994

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Schievink WI, , Prakash UB, & Piepgras DG, et al: αl-antitrypsin deficiency in intracranial aneurysms and cervical artery dissection. Lancet 343:452453, 1994 Schievink WI, Prakash UB, Piepgras DG, et al: αl-antitrypsin deficiency in intracranial aneurysms and cervical artery dissection. Lancet 343:452–453, 1994

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Sekhar LN, & Heros RC: Origin, growth, and rupture of saccular aneurysms: a review. Neurosurgery 8:248260, 1981 Sekhar LN, Heros RC: Origin, growth, and rupture of saccular aneurysms: a review. Neurosurgery 8:248–260, 1981

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Stebhens WE: Etiology of intracranial berry aneurysms. J Neurosurg 70:823831, 1989 Stebhens WE: Etiology of intracranial berry aneurysms. J Neurosurg 70:823–831, 1989

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    St Jean P, , Hart B, & Webster M, et al: Alpha-l-antitrypsin deficiency in aneurysmal disease. Hum Hered 46:9297, 1996 St Jean P, Hart B, Webster M, et al: Alpha-l-antitrypsin deficiency in aneurysmal disease. Hum Hered 46:92–97, 1996

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Teunissen LL, , Rinkel GJE, & Algra A, et al: Risk factors for subarachnoid haemorrhage. A systematic review. Stroke 27:544549, 1996 Teunissen LL, Rinkel GJE, Algra A, et al: Risk factors for subarachnoid haemorrhage. A systematic review. Stroke 27:544–549, 1996

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Vajda J: Multiple intracranial aneurysms: a high risk condition. Acta Neurochir 118:5975, 1992 Vajda J: Multiple intracranial aneurysms: a high risk condition. Acta Neurochir 118:59–75, 1992

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 2150 427 34
Full Text Views 314 40 6
PDF Downloads 221 23 8
EPUB Downloads 0 0 0