허혈성 뇌졸중환자에서 비파열 뇌동맥류

Abstract

Background: Intracranial aneurysms are often found in patients with ischemic stroke. Acute or chronic hemodynamic alterations of intracranial arteries, which frequently occur in patients with ischemic stroke, may affect on the characteristics of the aneurysms.

Methods: Of 1655 patients with ischemic stroke registered in Yonsei Stroke Registry, 578 patients who underwent cerebral angiography were enrolled in this study. Those with intracranial aneurysms were identified from this prospective registry. Patients with dissecting, fusiform, and mycotic aneurysms were excluded. Distribution and size of aneurysms, and clinical characteristics were investigated.

Results: Intracranial aneurysms were found in 24 patients(4.2%; 14 men and 10 women; aged 44 to 77 years, mean: 64) out of the 578 patients. Eighteen patients(75%) were hypertensives, eight(33%) were smokers, four(17%) had cardiac diseases, and three(12.5%) were diabetics. Aneurysms were single in 21 patients and multiple in 3. The aneurysms were most frequently found in the internal carotid artery(36%), followed by the middle cerebral artery(18%), posterior communicating artery(18%), anterior communicating artery(14%), anterior cerebral artery(11%), and superior cerebellar artery(3%). The aneurysms were less than 10 ㎜ in diameter in 26 patients(93%), and 10 ㎜ or more in 2(7%).

Conclusions: Unruptured aneurysms, incidentally found during cerebral angiography in acute inchemic stroke, are characteristically small, single, and located in the anterior circulation. However, the frequency and the distribution of them are similar to those reported in the general population