Prevalence of unruptured intracranial aneurysms among first-degree relatives of Thai patients who had aneurysmal subarachnoid hemorrhage.

BACKGROUND: The prevalence of familial unruptured intracranial aneurysm (UIA) in Thai population was unknown. METHODS: Our study population comprised first-degree relatives of patients who were diagnosed with aneurysmal subarachnoid hemorrhage (aSAH) in two cerebrovascular neurosurgical centers from January 2018 to December 2018. The volunteers underwent three-dimensional time-of-flight magnetic resonance angiography for screening intracranial aneurysms (IA). Those who were reported positive or suspected of IA then underwent computed tomography angiography for confirmation. RESULTS: We identified 12 patients who had 12 unruptured IAs (UIAs) from among 93 first-degree relatives. The prevalence of UIA among our study population was 12.9%. An estimated prevalence of UIA among Thai population was 9.05% (95% confidence interval [CI] 7.32-10.78). Of the 93 relatives, 84 had only one first-degree relative who suffered aSAH. Siblings posed a higher risk for UIA than offspring (16% vs. 9.5%), but the difference was not statistically significant (odds ratio 1.810, 95% CI 0.50-6.50, P = 0.274). The most common aneurysm location was the anterior cerebral artery territory (50%). CONCLUSION: The prevalence of familial UIA in a Thai population was relatively high. There was no significant between-group difference in the occurrence of UIA between the siblings and offspring of the aSAH patients.

Prevalence of intracranial aneurysms among acute ischemic stroke patients.

BACKGROUND: The prevalence of unruptured intracranial aneurysms varies with age, sex, and genetic diseases, including atherosclerotic diseases. The objectives of this study are to determine the prevalence of intracranial aneurysms among acute ischemic stroke patients and the clinical outcomes of the patients. METHODS: The authors included patients with acute ischemic stroke within 7 days of onset. Demographic data, stroke subtypes, risk factors, and modified Rankin scale (mRS) scores at 6 months after stroke were collected. Magnetic resonance angiography was performed to diagnose intracranial aneurysms. The occurrence of aneurysmal subarachnoid hemorrhage (aSAH) was recorded during the follow-up at 6 months. RESULTS: Thirteen (7%) of the 186 patients were found to have incidental intracranial aneurysms. Age and sex were not different between the patients with and without aneurysms (P > 0.999, P > 0.999). Ten patients (76.9%) had a saccular aneurysm. The most common site of the aneurysm was the cavernous part of the internal carotid artery (n = 6). Nine patients (69.2%) had very small (<4 mm) aneurysms. No aSAH was detected until 6 months after stroke. Favorable outcomes (mRS 0-2) at 6 months were not different between the patients with and without aneurysms (69.2% vs. 75.1%, P = 0.665). CONCLUSION: A higher prevalence of intracranial aneurysms was observed among acute ischemic stroke patients than among the general population. However, the variability of the general population should be considered. The functional outcomes of acute ischemic stroke patients are not affected by the presence of an intracranial aneurysm.

Outcomes of Surgical Treatment and Radiation Therapy in En Plaque Sphenoid Wing Meningioma.

Objective: En plaque sphenoid wing meningioma is a rare tumor. Complete surgical resection is difficult. Role of adjuvant radiation therapy in treatment of meningiomas is still controversial. This present study aimed to examine the clinical outcomes and to evaluate the role of adjuvant radiation for the residual tumors. Material and Method: A retrospective study was performed in 26 patients with en plaque sphenoid wing meningioma, who underwent operation at Prasat Neurological Institution between January 2008 and December 2012. Presenting symptoms, location of tumor, surgical approach, postoperative outcomes, and adjuvant radiation were reviewed and analyzed. Results: Among the 26 patients, their ages ranged from 31 to 57 years. All tumors were removed by transcranial approach. Eleven of the patients underwent adjuvant radiation therapy and post-radiation imaging revealed tumors being stable in size. Nine patients that had regrowth tumors were not radiated. Mean followed-up time was 51.77 months (range 18-96 months). Conclusion: Proptosis, visual acuity and cosmetic problems can be improved by surgery. Postoperative adjuvant radiation therapy may be an option for residual en plaque sphenoid wing meningioma.