Document Detail


Growth rates of intracranial aneurysms: exploring constancy.
MedLine Citation:
PMID:  18671627     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The annual rate of rupture of intracranial aneurysms is often assumed to be constant, but it is unknown whether this assumption is true. Recent case reports have suggested that aneurysms grow fast in a short period of time. The authors of the present report investigated the plausibility of a constant growth rate for intracranial aneurysms. METHODS: Assuming a constant aneurysm growth rate within an individual and varying rates between individuals, a hypothetical cohort was simulated. Individuals with high growth rates will display aneurysm formation and rupture at a young age; such persons disappear early from the hypothetical cohort. As a result the mean lesion growth rate varies over time. In hypothetical cohorts with different initial mean growth rates, the authors calculated age-specific incidence rates (per 100,000 person-years) of subarachnoid hemorrhage and compared these rates with population-based data on the incidence of subarachnoid hemorrhage (per 100,000 person-years). RESULTS: A hypothetical cohort with a mean initial growth rate of 0.18 mm/year reproduced most closely the incidence rates observed in the population. However, even for this most plausible hypothetical cohort, age-specific incidence rates in the model differed substantially and statistically significantly from those observed in the population. CONCLUSIONS: Based on the results of this study, it is unlikely that intracranial aneurysms in general grow at a constant time-independent rate. The authors hypothesized that the actual growth process is irregular and discontinuous, which results in periods with and without aneurysm growth and with high and low risks of rupture.
Authors:
Hendrik Koffijberg; Erik Buskens; Ale Algra; Marieke J H Wermer; Gabriel J E Rinkel
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  109     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-01     Completed Date:  2008-09-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  176-85     Citation Subset:  AIM; IM    
Affiliation:
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands. h.koffijberg@umcutrecht.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Distribution
Aneurysm, Ruptured / epidemiology,  pathology,  physiopathology
Cohort Studies
Computer Simulation*
Disease Progression
Humans
Incidence
Intracranial Aneurysm / epidemiology,  pathology*,  physiopathology*
Markov Chains
Middle Aged
Models, Biological*
Risk Factors
Subarachnoid Hemorrhage / epidemiology,  pathology*,  physiopathology*
Comments/Corrections
Comment In:
J Neurosurg. 2008 Aug;109(2):173-4; discussion 174-5   [PMID:  18671626 ]

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