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  • Prevalence of unruptured intracranial aneurysms (UIAs) examined in the trauma population

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Prevalence of unruptured intracranial aneurysms (UIAs) examined in the trauma population
  1. Barrett Schwartz1,
  2. Vincent Nguyen2,
  3. Michael Barats3,
  4. Mustafa Motiwala1,
  5. Sean Himel1,
  6. David M Weatherford4,
  7. Violiza Inoa-Acosta5,
  8. Nitin Goyal5,
  9. Nickalus R Khan1,5,
  10. Daniel Hoit1,5,
  11. Lucas Elijovich5,
  12. Adam S Arthur1,5,
  13. Christopher Nickele1,5
    1. 1Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
    2. 2Neurosurgery, University of Southern California, Los Angeles, California, USA
    3. 3Albany Medical College, Albany, New York, USA
    4. 4College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
    5. 5Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA
    1. Correspondence to Dr Christopher Nickele; cnickele{at}semmes-murphey.com

    Abstract

    Background Previous data on the prevalence of unruptured intracranial aneurysms (UIAs) vary widely, and studies based on these data are plagued with unintentional bias. Accurate prevalence data are paramount for any physician who counsels patients with intracranial aneurysms on rupture risk and treatment. We therefore sought to determine a more accurate number for the true prevalence of UIAs.

    Methods A retrospective chart review was conducted at a level 1 trauma center and tertiary care hospital in an urban setting between 2019 and 2020. Inclusion criteria included patients admitted with blunt trauma. Exclusion criteria included not having a head and neck CTA performed and read by an attending radiologist. All head and neck CTA radiology reads were reviewed for incidentally discovered UIAs. Subgroup analysis was performed by age group, race, and gender.

    Results A total of 5978 out of 8999 patients met the inclusion criteria, and 54 patients with 58 total aneurysms were identified giving an overall prevalence of 0.9%. Subgroup analysis was performed for all age groups, genders, and racial groups.

    Conclusion The overall aneurysm prevalence was found to be 0.9% in this sample. This rate is lower than rates previously cited in the literature and those quoted in local practice. This finding has significant implications when attempting to understand average rupture risk. Further studies are needed to power more subgroup analyses to use a more personalized approach to understanding an individual’s risk of rupture.

    • Trauma
    • Aneurysm

    Data availability statement

    Data are available in a public, open access repository. Data are available upon reasonable request. Patient information would need to be deidentified prior to sharing.

    https://doi.org/10.1136/jnis-2024-022154

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      Data availability statement

      Data are available in a public, open access repository. Data are available upon reasonable request. Patient information would need to be deidentified prior to sharing.

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      Footnotes

      • X @vnnguyen, @HimelSean, @InoaVioliza, @KhanNickalus, @AdamArthurMD, @DrNickele

      • Contributors All authors of this work met ICMJE criteria for authorship and made substantial contributions to the conception and design (BS, VN, CN), acquisition of data (BS, VN, MB, MM, SH, DMW), analysis and interpretation of data (BS, VN, VI-A, NRK, NG, LE, DH, ASA, CN), drafting (BS, VN, CN), critical revising (BS, VI-A, NRK, NG, LE, DH, ASA, CN), and final approval (CN) of this manuscript. The guarantor of this manuscript is CN.

      • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

      • Competing interests VI-A is a consultant for Siemens and Penumbra and received research support from Medtronic. DH is a consultant for Covidien/Medtronic and Microvention and is a shareholder of Cerebrotech, Marblehead Medical, and Silver Bullett. LE is a consultant for Balt, Cerenovus, Medtronic, MicroVention, Penumbra, and Stryker. ASA is a consultant for Johnson and Johnson, Medtronic, Microvention, Penumbra, Scientia, Siemens, and Stryker; received research support from Balt, Cerenovus, Medtronic, Microvention, Penumbra, Siemens, and Stryker; and is a shareholder in Bendit, Cerebrotech, Endostream, Magneto, Marble-head, Neurogami, Serenity, Synchron, TriadMedical, and VascularSimulations. CN is a consultant for Leica and received research support from Microvention.

      • Provenance and peer review Not commissioned; externally peer reviewed.