Incidental unruptured intracranial aneurysms in patients with acute ischemic stroke.
BACKGROUND
The management and clinical prognosis of incidental intracranial aneurysms in acute ischemic stroke patients have been understudied. We investigated the clinical outcome of acute ischemic stroke subjects with incidentally found intracranial aneurysms.


METHODS
We consecutively included acute ischemic stroke patients within 7 days of onset. Their demographics, risk factors, stroke subtypes, antithrombotics use and modified Rankin scale (mRS) at 3 months after stroke were obtained. CT or MR angiography was used to diagnose the intracranial aneurysms. The development of an aneurysmal rupture was checked during the following 3 months.


RESULTS
Incidental intracranial aneurysms were found in 17 (6.6%) of the 258 patients. The female sex and old age were associated with the presence of incidental intracranial aneurysms (p = 0.001, 0.032). The most common site of aneurysm was at the distal internal carotid artery (n = 9), followed by the middle cerebral artery (n = 6). The diameters of the aneurysms ranged from 2.09 to 8.06 mm. All the participants except 1 who had cancer were taking antiplatelet agents. No aneurysmal rupture or subarachnoid hemorrhage happened until 3 months after stroke.There was no significant difference in excellent outcome (3-month mRS = 0, 1) between the patients with an aneurysm and those without (28.6 vs. 53.4%, p = 0.097).


CONCLUSIONS
There was no rupture of the incidentally found aneurysms in the patients with acute ischemic stroke during their first 3 months. The 3-month mRS was not affected by the presence of incidental intracranial aneurysm. A large cohort study and long-term follow-up are required.
Oh
Yoon-Sang
YS
Department of Neurology, Catholic University of Korea, St. Mary's Hospital, Seoul, South Korea.
Lee
Seung-Jae
SJ
Shon
Young-Min
YM
Yang
Dong Won
DW
Kim
Beum Saeng
BS
Cho
A-Hyun
AH
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000453:epidemiology; D002545:Brain Ischemia / Q000150:complications* / Q000628:therapy; D002340:Carotid Artery Diseases / Q000150:complications; D002343:Carotid Artery, Internal / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications; D033162:Incidental Findings; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012306:Risk; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors