Cervical arterial abnormalities and outcome after aneurysmal subarachnoid haemorrhage: A pilot cohort study.

BACKGROUND: Cervical arterial abnormalities are associated with intracranial aneurysm but their frequency and association with outcome in case of aneurysmal subarachnoid haemorrhage (aSAH) remains unknown. METHODS: Data were retrospectively extracted from a prospective database. Consecutive angiographies of aSAH patients on a 13-month period were reviewed as well as consecutive angiographies of SAH patients without evidence of aneurysm on a 20-month period. Occurrence of secondary neurological complications was collected with 3-month functional outcome (modified Rankin Scale ≥ 3 was considered as poor outcome). Cervical arterial abnormalities on angiographies were classified into two subcategories: trajectory and lumen vessel abnormalities. RESULTS: Forty-five patients displayed aneurysmal rupture (aSAH) while 39 patients had no evidence of aneurysm (non-aneurysmal SAH). Prevalence of cervical arterial abnormalities in aSAH and non-aneurysmal SAH patients were 82% (n = 37) and 64% (n = 25), respectively (p = 0.082). Lumen vessel abnormalities were significantly more frequent in case of aSAH (n = 31; 69%) than non-aneurysmal SAH: (n = 9; 23%; p < 0.001). Twenty-eight (62%) aSAH patients experienced poor outcome at 3 months. Lumen vessel abnormalities were significantly associated with 3-month poor outcome (74% (n = 23) versus 36% (n = 5); p = 0.021) without any significant increased occurrence of secondary complications such arterial vasospasm or delayed cerebral ischemia. CONCLUSION: Cervical arterial abnormalities are frequent in a cohort of aSAH patients. Lumen vessel abnormalities are associated with 3-month poor outcome.

Cervical artery tortuosity is associated with intracranial aneurysm.

Background Intracranial aneurysms may be associated with an underlying arteriopathy, leading to arterial wall fragility. Arterial tortuosity is a major characteristic of some connective tissue disease. Aim To determine whether intracranial aneurysm is associated with an underlying arteriopathy. Methods Using a case-control design, from May 2012 to May 2013, we selected intracranial aneurysm cases and controls from consecutive patients who had conventional cerebral angiography in our center. Cases were patients with newly diagnosed intracranial aneurysm. Controls were patients who had diagnostic cerebral angiography and free of aneurysm. The prevalence of tortuosity, retrospectively assessed according to standard definitions, was compared between cases and controls and, association between tortuosity and some aneurysm characteristics was examined, in cases only. Results About 659 arteries from 233 patients (112 cases and 121 controls) were examined. Tortuosity was found in 57 (51%) cases and 31 (26%) controls (adjusted OR = 2.71; 95%CI, 1.53-4.80). The same trend was found when looking at each tortuosity subtype (simple tortuosity, coil, kink) or at carotid or vertebral territory separately. In contrast, no association between tortuosity and rupture status, aneurysm number or neck size was found. Conclusions Cervical artery tortuosity is significantly associated with intracranial aneurysm, although not related to main aneurysm characteristics. Our results support the presence of an underlying diffuse arteriopathy in intracranial aneurysm patients.