Comparison of the Prevalence of Ruptured and Unruptured Cerebral Aneurysms in a Poor Urban Minority Population

• Published in: Journal of stroke and cerebrovascular diseases Vol. 26; no. 10; pp. 2287 - 2293
• Main Authors: Miller, Todd S., MD, Altschul, David, MD, Baxi, Nrupen, MD, Farinhas, Joaquim, MD, Pasquale, David, MD, Burns, Judah, MD, Gordon, David, MD, Bello, Jacqueline, MD, Brook, Allan, MD, Flamm, Eugene, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2017
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Aneurysm; Aneurysm, Ruptured - diagnostic imaging; Aneurysm, Ruptured - epidemiology; Cardiovascular; Cerebral Angiography; Child; epidemiology; Female; Humans; Intracranial Aneurysm - diagnostic imaging; Intracranial Aneurysm - epidemiology; Magnetic Resonance Angiography; Male; Middle Aged; Minority Groups; Neurology; Poverty; Prevalence; Retrospective Studies; socioeconomic status; subarachnoid hemorrhage; Urban Population; Young Adult; epidemiology; socioeconomic status; subarachnoid hemorrhage; Aneurysm
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2017.05.012

Background Most ruptured cerebral aneurysms are small (<7 mm). Evidence suggests low rupture rates for such lesions (<1% per year). Population studies demonstrate a prevalence rate of 3.2%. This study simultaneously estimates the prevalence of aneurysms in a single geographic population while reporting the observed rate of aneurysmal subarachnoid hemorrhage (aSAH) in the same geographic region composed of a poor urban minority demographic. Methods This is an institutional review board-approved, Health Insurance Portability and Accountability Act of 1996-compliant retrospective study performed between 2005 and 2011 at a single center. Part 1 used the electronic medical record to identify all patients with a magnetic resonance angiography demonstrating a cerebral aneurysm. Part 2 used the electronic medical record to identify all patients from the same geographic area presenting with aSAH during the study period. Results A total of 11,160 subjects had a magnetic resonance angiography from the study area. In this group, 422 intradural cerebral aneurysms were incidentally discovered. Ninety-one percent were less than 10 mm (mean 5.49, standard deviation 4.6). Twenty-one percent were aneurysms of the anterior communicating artery complex. Fourteen percent were of posterior communicating artery origin. A total of 237 patients had aSAH. Ninety-two percent of the aneurysms were less than 10 mm (mean 6 mm, standard deviation 3.2 mm). Both groups were composed of poor urban minority patients. Conclusions The observed annual rate of rupture of small anterior circulation aneurysms in this study was .06%-.15% per year. The extrapolated population prevalence of such aneurysms (4.0%-1.5%) may explain the observed rate of rupture of these small aneurysms in a poor urban minority population.