Clinical Characteristics And Prognostic Factors Of Unruptured Intracranial Aneurysms With Cerebral Infarction

Objective To investigate the demographic characteristics of unruptured intracranial aneurysms patient with cerebral infarction,and to observe the effect of different management regimens on the overall prognosis of these patients.To investigate the effects of oral aspirin on unruptured intracranial aneurysms,to analyze the safety and efficacy of aspirin in the treatment of UIA patients with cerebral infarction.Methods 1.From 2011 to 2016 in the First Affiliated Hospital of Fujian Medical University,52 patient who first diagnosed unruptured intracranial aneurysms combined with cerebral infarction was included,collected the clinical information of these patient.The unruptured intracranial aneurysms patients without cerebral infarction(Simple aneurysm group)and the cerebral infarction patient without intracranial aneurysm(simple cerebral infarction group)as the control group,to analyze the difference of demographic characteristics.2.Depending on the management program,the patients were divided into 4 groups,surgical clipping group(N = 12),endovascular treatment group(n = 5),oral aspirin group(n = 17)and untreated group(n = 18).Modified Rankin score(MRS)were used to assess the prognosis of patient,When the patient is discharged and 1 year after discharged.3.Recommend the patient back to review the CTA or MRA or DSA,and collect the imaging data of oral aspirin group(n = 17)and untreated group(n = 18),Contrast with the imaging data at the time of hospitalization,to explore the effect of oral aspirin on the outcome of unruptured intracranial aneurysms.Result 1.Demographic characteristics: gender,age,hypertension,diabetes,smoking history combined with other system history,percentage of lymphocytes were statistically significant between the simple UIA group and the UIA combined with cerebral infarction group.These statistically significant factors were introduced into the logistics regression model for multivariate analysis.The results showed that age,hypertension,and lymphocyte percentage ware an independent risk factor for cerebral infarction in UIA patients(OR > 1).Compared to the patients with cerebral infarction,the age,CRP and carotid Intima-Media Thickness(IMT)> 0.09 cm were statistically significant differences between the two groups.These statistically significant indicators were introduced into the logistics regression model for multivariate analysis.The results showed that carotid IMT< 0.09 cm was associated with the development of UIA in patients with cerebral infarction,OR <1,suggesting that cerebral arteriosclerosis is a protective factor for UIA in patients with cerebral infarction.2.Follw up: According to the difference of management program,patient ware divided into four groups,The MRS score when the patient is discharged of the untreated group was lower than the oral aspirin group(P <0.05).The oral aspirin group compare with the surgical clipping group and the endovascular treatment group,the MRS score when the patient is discharged was no significant difference.There was no significant difference of the MRS score at 1 year after discharged between the oral aspirin group and the other groups(P> 0.05).3.Changes of unruptured intracranial aneurysms: patients review MRA,CTA,DSA after discharge,6 patients of oral aspirin group returned to hospital to review,the average follow-up time of 19.8 months,2 cases of aneurysm smaller than before,4 cases of aneurysm size unchanged.5 cases of untreated group returned to hospital to review,The average follow-up time was 18.4 months.There were 2 cases of aneurysms becoming larger,2 cases of aneurysms unchanged,and 1 case of aneurysms became smaller.Conclusion Age,hypertension,percentage of lymphocytes,combined with cerebral atherosclerosis is a risk factor for cerebral infarction in UIA patients.Intracranial aneurysm have a negative correlation with carotid IMT,combined with a case of carotid intima thickening higher than before but aneurysm disappeared,we speculated: the development of carotid IMT provides protection against the UIA.Oral aspirin as a management of the UIA patient combined cerebral infarction,does not increase the risk of intracranial hemorrhage;and its effectiveness to protect UIA need Future investigation in clinical studies to explore.