Abstract 280: Factors Influencing Aneurysmal Subarachnoid Hemorrhage Burden

• Published in: Stroke: vascular and interventional neurology 2024-11, Vol.4 (S1)
• Main Authors: Gudino, A S, Sagues, E, Dier, C, Sanchez, S, Cabarique, M, A Van Dam, Shenoy, N, Aamot, C, Samaniego, E
• Format: Article
• Language: English
• Subjects: Aneurysms; Hemorrhage; Morphology
• ISSN: 2694-5746; 2694-5746
• DOI: 10.1161/SVIN.04.suppl_1.280

Introduction/PurposeIt is not known if there is a relationship between patients age, gender, aneurysm morphology, and location, with subarachnoid hemorrhage (SAH) volume. This study aims to explore if larger aneurysms, or aneurysms in certain locations are associated with larger aneurysmal SAH volume, and therefore, have worse outcomes.Materials/MethodsPatients with an aneurysm rupture and a non‐contrast computed tomograpy (NCCT) were included. A semi‐automated software, based on Hounsfield Unit thresholds, was used to quantify the total intracranial hemorrhage volume using MATLAB. Aneurysm morphology was assessed using angiographic studies. Aneurysm size, size ratio (SR), aspect ratio (AR), and aneurysm morphology such as irregularity were determined. Additionally, aneurysms were classified as either bifurcating or sidewall independently of morphological features.ResultsA total of 200 aneurysms were analyzed. Similar volume of hemorrhage was found between aneurysm location (p 0.320). However, basilar tip aneurysms bleed more (36.2 ml, IQR: 34.5). Aneurysms located in bifurcation locations experienced higher SAH volume compared to sidewall aneurysms (23.16 ml, IQR: 34.2 vs 11.95 ml, IQR: 20.9, p 0.002). No relationship was found between aneurysm size (Rho 0.178), SR (Rho 0.217), and AR (Rho 0.148) with subarachnoid hemorrhage volume. In multivariate analysis, female gender was an independent predictor of lower hemorrhage volumes (OR 0.58, 95% CI 0.41 ‐ 0.80, p 0.001). Conversely, elderly population (OR 1.03, 95% CI 1.01 ‐ 1.04, p < 0.001) and bifurcating aneurysms (OR 1.59, 95% CI 1.17 to 2.15, p 0.003, figure 1) were independent predictors of larger SAH volumes.ConclusionBasilar tip aneurysms bleed more. Female patients experience less hemorrhage volume. Aneurysms in bifurcating locations and older patients are more likely to present with larger SAH volumes. Aneurysm size, SR, AR, and irregularity were not associated with SAH volume.