The role of gender, age and localization in the clinical manifestation of the cerebral bifurcational-hemodynamic arterial aneurysms
Objective ‒ to evaluate the influence of age, gender and localization on the clinical manifestation of cerebral bifurcational-hemodynamic arterial aneurysms (AA).
Materials and methods. The retrospective study is based on the results of a comprehensive examination and surgical treatment of 547 (100 %) patients with bifurcational-hemodynamic cerebral AA in the Department of neurosurgical pathology of head and neck vessels of Romodanov Neurosurgery Institute during the period from 2011 till 2019. Recruiting of the patient to the clinical groups was done during the period between 2011‒2016 with their follow-up examination until 2019. It were enrolled 268 ((49.0 ± 4.2) %) men and 279 ((51.0 ± 4.2) %) women with bifurcational-hemodynamic aneurysms. The age of the patients was 18‒84 years (mean age ‒ 49,0±12,2 year).
Results. Clinical manifestation of the cerebral bifurcational-hemodynamic AA was more often seen in patients during working age (16‒60 years) — 430 ((78.5 ± 3.4) %) patients, more often in men (p˂0.05). The peak frequency of clinical manifestation of AA ‒ 34.2 % (187 patients) was seen in the age interval 51‒60 years (the male/female ratio ‒ 51.3 % (96) and 48.7 % (91)). In patients with AA, a significant predominance of women was observed in age group older 61 years (χ2 = 21.68, p <0.001, φ = 0.20). There was no statistically significant relationship between the frequency of clinical manifestation of AA and the patient’s age. However, there is a statistically significant relationship between gender and age in some locations. The percentage of patients with AA complex of the anterior cerebral-anterior communicating artery among women is 62.5 ± 15.0 (25/40, after 60 years it’s in 1.7 times higher than among men 37.5 ± 15.0 (15/40). While before the age of 61, there is a 1.6-fold increase in men, 61.3 ± 7.5 (100/163). For the internal carotid artery segments, the percentage of patients who underwent AA among women is 81.6 ± 12.0 (31/38), after 60 years it is in 4.4 times higher than among men 18.4 ± 12.0 (7/38). For the middle cerebral artery, the percentage among women is 73.1 ± 17.4% (19/26), after 60 years it is in 2.7 times higher than in men 6.4 ± 17.7% (7/26). Until the age of 61, the gender difference in the internal carotid artery and the middle cerebral artery segments does not reach a statistically significant level (p> 0.05). At other localizations, gender-age dependence was not observed. Multiple cerebral aneurysmal lesions were associated with clinical manifestation at the age of 41‒50 years in males with 3 AA.
Conclusions. A statistically significant influence of age, gender and the presence of multiple cerebral AA on the clinical manifestation of the disease was revealed. Localization of AA did not affect the timing of the clinical manifestation.
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