Smaller cerebral aneurysms producing more extensive subarachnoid hemorrhage following rupture: a radiological investigation and discussion of theoretical determinants.
OBJECTIVE
The goal of this study was to determine the relationship between aneurysm size and the volume of subarachnoid hemorrhage (SAH).


METHODS
One hundred consecutive patients who presented with acute SAH, which was diagnosed on the basis of a computerized tomography (CT) scan within 24 hours postictus and, subsequently, confirmed to be aneurysmal in origin by catheter angiography, were included in this study. The data were collected prospectively in 32 patients and retrospectively in 68. The volume of SAH on the admission CT scan was scored in a semiquantitative manner from 0 to 30, according to a previously published method. The mean aneurysm size was 8.3 mm (range 1-25 mm). The mean SAH volume score was 15 (range 0-30). Regression analysis revealed that a smaller aneurysm size correlated with a more extensive SAH (r(2) = 0.23, p < 0.0001). Other variables including patient sex and age, intraparenchymal or intraventricular hemorrhage, multiple aneurysms, history of hypertension, and aneurysm location were not statistically associated with a larger volume of SAH.


CONCLUSIONS
Smaller cerebral aneurysm size is associated with a larger volume of SAH. The pathophysiological basis for this correlation remains speculative.
Russell
Stephen M
SM
Department of Neurosurgery, New York University School of Medicine, New York, New York 10016, USA.
Lin
Ke
K
Hahn
Sigrid A
SA
Jafar
Jafar J
JJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D018608:Ultrasonography, Doppler