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. 2015 Nov;46(11):3093-8.
doi: 10.1161/STROKEAHA.115.011351. Epub 2015 Oct 8.

Risk Factors Associated With the Presence of Unruptured Intracranial Aneurysms

Hyun Goo Kang  1 , Bum Joon Kim  1 , Jisung Lee  1 , Mi-Jung Kim  1 , Dong-Wha Kang  1 , Jong S Kim  1 , Sun U Kwon  2
Affiliations

Risk Factors Associated With the Presence of Unruptured Intracranial Aneurysms

Hyun Goo Kang et al. Stroke. 2015 Nov.

Abstract

Background and purpose: With the increased investigation of cerebral arteries using magnetic resonance angiography in the general population, the detection of unruptured intracranial aneurysms (UIAs) has increased. Understanding the distribution and factors associated with UIAs might be helpful for understanding the pathomechanism.

Methods: Subjects who underwent magnetic resonance angiography with a health examination at the Health Screening and Promotion Center were enrolled. The incidence and risk factors of UIAs (age, sex, hypertension, diabetes mellitus, smoking, alcohol, and coronary artery disease) were investigated by comparing patients with and without UIAs. These risk factors were also investigated by the UIA location, distal internal carotid artery, anterior cerebral artery and middle cerebral artery (MCA), MCA bifurcation, anterior and posterior communicating artery, and posterior circulation.

Results: Among 187 166 subjects who received health examination, 18 954 underwent magnetic resonance angiography. Of them, 367 (1.93%) had UIAs. Age (odds ratio [OR], 1.02; P=0.003), women (OR, 2.00; P<0.001), hypertension (OR, 2.21; P<0.001), smoking (OR, 1.66; P=0.001), and coronary artery disease (OR, 0.23; P<0.001) were independently associated with the presence of UIAs. Hypertension was associated with most UIAs, except for those located at sidewalls (anterior cerebral artery and MCA). MCA aneurysms were associated with old age and smoking. Distal internal carotid artery, posterior communicating artery, and MCA-bifurcation aneurysms were associated with female sex. Anterior communicating artery aneurysms were associated with smoking and alcohol. Posterior circulation UIAs were only associated with hypertension. Coronary artery disease was negatively associated with anterior circulation aneurysms.

Conclusions: The risk factors for UIAs differ by their location, compared with the control. Interestingly, the presence of coronary artery disease was protective against the presence of UIAs.

Keywords: circle of Willis; coronary artery disease; intracranial aneurysm; middle cerebral artery; risk factors.

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