Risk factor analysis of intracranial hemorrhage with varying extent due to ruptured anterior communicating artery aneurysms

Objective To investigate the risk factors of intracerebral hematoma(ICH) and/or intraventricular hemorrhage(IVH) with varying extent due to ruptured AComA (anterior communicating artery) aneurysms. Methods Between December 2007 and January 2016, a total of 480 consecutive patients with ruptured AComA aneurysms were admitted to Department of Neurosurgery, the First Affiliated Hospital, Wenzhou Medical University and enrolled into this retrospective study. Among them, embolization was conducted in 244 cases, clipping in 172 and conservative treatment in 64. All 480 cases were divided into the SAH (subarachnoid hemorrhage) group (n=195) and ICH and/or IVH group (n=285). Single and multiple variate logistic regression were used to identify the risk factors associated with ICH and/or IVH due to rupture of aneurysms. Results The single-variate analysis revealed significant differences in the gender, age, aneurysm projection between 2 groups (all P<0.05). The multivariate analysis showed that the age (OR=1.025, 95% CI: 1.009-1.041, P=0.002) and aneurysm projection (OR=1.698, 95% CI: 1.092-2.639, P=0.019) were associated with ICH and/or IVH following rupture of aneurysms. Conclusions The age and aneurysm projection seem to be significantly associated with ICH and/or IVH induced by ruptured AComA aneurysms. In clinical practice, close attention should be paid to the elderly patients and those with aneurysms projecting to the posterior. Key words: Intracranial aneurysm; Aneurysm, ruptured; Root cause analysis; Anterior communicating artery; Intracerebral hematoma; Intraventricular hemorrhage