A Retrospective Analysis On 272 Intracranial Ruptured Aneurysms

Objective: To explore the clinical characteristics of the patients with the cerebral ruptured aneurysms smaller than 7mm and the predilection site of this kind of cerebral ruptured aneurysms.Methods: We retrospectively analyzed 263 patients with cerebral aneurysms, which were certificated by conventional angiography and operation because of the intracranial hemorrhages at our institute between Jan 2005 and Dec 2006. There were 272 ruptured aneurysms among 263 patients, to analyze the different size and the number of this aneurysms, and to divide them into two groups according to the standard of 7mm, the group <7mm and the group≥7mm, then to analyze the distributive characteristic of the different location in the intracalvarium between this two groups and to see whether there were statistical difference between this two groups in the constituent ratio of the patients, blood pressure, age, sex, blood glucose, blood fat and the uric acid. The comparison on the categorical variable was described by constituent ratio, and was statistically analyzed using theχ2 test, logistic regression was used to analyze the factors affecting the size of the ruptured cerebral aneurysms and to analyze the influential factors of the <7mm ruptured cerebral aneurysms. The Backward Stepwise(LR)was used to screen the possible influential factors, the standard to be selected was 0.05, the standard to be discharged was 0.10.Result: There were 272 cerebral ruptured aneurysms among 263 patients, 9 patients had double ruptured aneurysms. Among the ruptured aneurysms, the smallest was 2.2mm and the largest was 32mm in diameter, the mean diameter was (7.00±4.33)mm. Of 272 aneurysms, 175(64.34%) were smaller than 7mm, 97(35.66%) were larger than 7mm. The numbers of the ruptured cerebral aneurysms of the patients at the age ranged from 50 to 60 years was 108(41.10%), which were obviously more than other ages. The one-way analysis showed that there were no statistical difference between this two groups among the distribution of the patients, age, sex, blood glucose, blood fat and the uric acid (p>0.05). The ratio of hypertension in the group <7mm was higher than the group≥7mm(p<0.05), there were statistical significance among the distribution of the different location in the intracalvarium between this two groups(p<0.05), the proportion of the group <7mm was higher than the group≥7mm in the following four situations: the anterior cerebral artery(ACA),the anterior communicating artery(AcomA),the middle cerebral artery(MCA) and the internal carotid artery—posterior communicating artery(ICA—PcomA), Logistic regression analysis showed that the hypertension, ACA,AcomA,MCA,ICA-PcomA, especially ACA and AcomA were the influential factors for the ruptured cerebral aneurysms smaller than 7mm.Conclusion: As far as the sample document collected currently concerned, compare to the≥7mm ruptured cerebral aneurysms, the <7mm ruptured cerebral aneurysms may be more prone to occur in the patients with hypertension and the locations including the ACA,the AcomA,the MCA and the ICA-PcomA, especially in the ACA and the AcomA; it should be pay more attention for clinician to the cerebral aneurysms smaller than 7mm whether they are ruptured or unruptured when they occur in such locations and when they accompanied by hypertension.