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Neurology
Original research
Trend of cerebral aneurysms over the past two centuries: need for early screening
  1. Arjun Burlakoti1,2,
  2. Jaliya Kumaratilake2,
  3. Jamie Taylor3,
  4. Maciej Henneberg2,4
  1. 1Human Anatomy, University of South Australia, Adelaide, South Australia, Australia
  2. 2School of Biomedicine, Faculty of Health and Medical Sciences, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
  3. 3South Australia Medical Imaging, Royal Adelaide Hospital, Adelaide, South Australia, Australia
  4. 4Institute of Evolutionary Medicine, The University of Zurich, Zürich, Switzerland
  1. Correspondence to Dr Arjun Burlakoti; arjun.burlakoti{at}unisa.edu.au

Abstract

Objective Cerebral aneurysms (CAs) are linked to variations in the cerebral basal arterial network (CBAN). This study aimed to find the optimal age for screening to detect brain arterial variations and predict aneurysms before rupture.

Design An observational, quantitative and retrospective research.

Setting The study analysed 1127 cases of CAs published from 1761 to 1938. Additionally, CT angiography images of 173-patients at the Royal Adelaide Hospital (RAH), South Australia between 2011 and 2019 were examined for the presence and the location of aneurysms in CBAN.

Participants The data were collected from patients at RAH and 407 published sources, including males and females across the entire age range, up to 100 years old.

Outcome measures and results Data, CAs cases, from 1761 to 1938 included (526 males, 573 females and 28 unknown sexes). The age of these patients varied from 18 months to 89 years (mean age=42, SD=18). Approximately 11.5% of the CAs occurred in patients aged <20 years. Among the 1078 aneurysms whose location was reported, 76% were located in the internal carotid (IC), middle cerebral (MC) and anterior communicating artery complex (AcomAC) regions, while the remaining 24% were in the vertebrobasilar region. Among 173 patients from RAH aged between 18 and 100 years (male=83 and female=90, mean age=60, SD=16), 94% of the CAs were found in the IC, MC and AcomAC regions. The pattern of aneurysm occurrence, as indicated by values at the 25th, 50th and 75th percentiles, along with the minimum and maximum patient ages, has remained consistent from 1761 to 2019.

Conclusion The distribution pattern of CAs in relation to sex, age and locations in the CBAN, remained steady over the last 260 years resulting in risk of strokes early in life. Therefore, early screening for CBAN segment variations is advised for stroke prevention if possible.

  • health policy
  • stroke
  • mass screening
  • community child health

Data availability statement

Data are available on reasonable request. Not applicable/uploaded as supplementary information.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi-org.ezproxy.u-pec.fr/10.1136/bmjopen-2023-081290

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    Data availability statement

    Data are available on reasonable request. Not applicable/uploaded as supplementary information.

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    Footnotes

    • Twitter @draburlakoti

    • Contributors AB is responsible for the overall content as the guarantor and accepts full responsibility for the work and the conduct of the study, has access to the data ands control the decision to publish. AB conceived the idea, collected and analysed both sets of data, took pictures, recorded videos, contributed to conceptualisation, prepared and drafted the manuscript. JK conceived the idea, contributed to the concept, aided in data interpretation, editing and the revision of the manuscript and approving the article. JT conceived the idea, contributed to the concept, aided in data interpretation, editing and the revision of the manuscript and approving the article. MH conceived the idea, masterminded and helped in statistics, data analysis and interpretation, editing and approving the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.