Aneurysm rupture risk factors

In Kazakhstan a study has revealed that younger, smoking patients with stage 3 arterial hypertension are at higher risk for Ruptured intracranial aneurysms (RIA) . Small intracranial aneurysms (< 6 mm) and location on ACA had increased odds of rupture, while larger aneurysms on internal carotid arteries had lower odds 1)

Risk factors include:

High blood pressure. High blood pressure damages and weakens arteries, making them more likely to form and to rupture.

Size. The largest aneurysms are the ones most likely to rupture in a person who previously did not show symptoms.

Location. Aneurysms located on the posterior communicating arteries (a pair of arteries in the back part of the brain) and possibly those on the anterior communicating artery (a single artery in the front of the brain) have a higher risk of rupturing than those at other locations in the brain.

Growth. Aneurysms that grow, even if they are small, are at increased risk of rupture.

A family history of aneurysm rupture suggests a higher risk of rupture for aneurysms detected in family members.

The greatest risk occurs in individuals with multiple aneurysms who have already suffered a previous rupture or sentinel bleed.

Results suggest that high cotinine levels in smokers with brain aneurysms are significantly associated with high rupture risk, independently of smoker status, age, and sex 2)

Cerebrovascular atherosclerotic stenosis (CAS) and intracranial aneurysm (IA) have a common underlying arterial pathology and common risk factors, but the clinical significance of CAS in IA rupture (IAR) is unclear. A study of Feng et al. aimed to investigate the effect of CAS on the risk of IAR.

They observed substantial differences in the severity of atherosclerotic stenosis, parent-artery stenosis, number of stenotic arteries, and intracranial/extracranial stenosis as indicators between ruptured and unruptured aneurysms. CAS is significantly associated with the risk of intracranial aneurysm rupture, whether in patients aged ≥65 years or <65 years. These findings indicate the clinical significance of CAS in IAR 3).

Medetov Y, Babi A, Makhambetov Y, Menlibayeva K, Bex T, Kaliyev A, Akshulakov S. Risk factors for aneurysm rupture among Kazakhs: findings from a national tertiary. BMC Neurol. 2022 Sep 20;22(1):357. doi: 10.1186/s12883-022-02892-y. PMID: 36127629.
Missori P, de Sousa DA, Ambrosone A, Currà A, Paolini S, Incarbone G, Amabile E, Biraschi F, Diana F, Peschillo S. Cotinine levels influence the risk of rupture of brain aneurysms. Acta Neurol Scand. 2022 Aug 3. doi: 10.1111/ane.13679. Epub ahead of print. PMID: 35920037.
Feng X, Qi P, Wang L, Lu J, Wang HF, Wang J, Hu S, Wang D. Relationship between cerebrovascular atherosclerotic stenosis and rupture risk of unruptured intracranial aneurysm: A single-center retrospective study. Clin Neurol Neurosurg. 2019 Oct 1;186:105543. doi: 10.1016/j.clineuro.2019.105543. [Epub ahead of print] PubMed PMID: 31627063.
  • aneurysm_rupture_risk_factors.txt
  • Last modified: 2022/09/21 09:53
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