DEMOGRAPHIC AND CLINICAL IMPLICATIONS OF SACCULAR CEREBRAL ANEURYSM LOCALIZATION
Authors: Shchehlov D. V. , Svyrydiuk O. Y. , Pankiv V. R. , Slobodyan O. V. 
Published: January 2025

Introduction. Saccular cerebral aneurysms (SAs) are small, sac-like outpouchings that occur within the cerebral vasculature. These lesions, although often asymptomatic, can pose significant clinical risks if they rupture, leading to subarachnoid hemorrhage (SAH). The prevalence of SAs varies across different arterial basins, with a higher incidence reported in the anterior cerebral and anterior communicating arteries (ACA-ACoA). This study aims to explore the relationship between the localization of SAs, their clinical manifestations, and the demographic characteristics of affected patients.
Objective. The primary objective of this study is to establish the correlation between the localization of saccular cerebral aneurysms, their clinical manifestations, and the demographic characteristics of the patients, such as age and gender.
Materials and Methods. This retrospective study analyzed the medical records of 48 patients diagnosed with saccular cerebral aneurysms of various localizations who received treatment at the Scientific and Practical Center for Endovascular Neuroradiology of the National Academy of Medical Sciences of Ukraine from 2020 to 2023. Ethical approval was obtained from the institutional review board, and informed consent was secured from all patients. Diagnostic tools included spiral computed tomography angiography (SCTA), magnetic resonance angiography (MRA), and cerebral angiography (CA). The severity of subarachnoid hemorrhage (SAH) was assessed using the Fisher grading scale. Statistical analyses were performed using IBM SPSS 26.0, employing chi-square tests for qualitative data, Student's t-tests and ANOVA for quantitative data, and Pearson correlation analysis. A p-value of <0.05 was considered statistically significant.
Results. The study population consisted of patients with a mean age of 45.1 ± 16.76 years, reflecting a diverse age range within the cohort. A detailed analysis of the anatomical locations of saccular aneurysms (SAs) revealed that the anterior cerebral artery (ACA) was the most frequently affected site, exhibiting a notable prevalence of 51.5%. This was followed by the internal carotid artery (ICA), which accounted for 32% of the cases, and the middle cerebral artery (MCA), where the prevalence was recorded at 19%. Interestingly, the distribution of SAs across these different arterial locations showed no significant differences when analyzed in relation to the patients' age or gender. Furthermore, a comprehensive analysis indicated that there was no significant correlation between the localization of SAs and the severity of subarachnoid hemorrhage (SAH), as classified by the Fisher scale. Patients who exhibited SAH showed a higher prevalence of SAs in the ICA at 70%, with 50% of cases located in the ACA-ACoA and 60% in the MCA. Despite these observations, no statistically significant differences were found between the groups of patients with SAH and those without, indicating that the presence of SAH did not markedly alter the pattern of aneurysm localization.
Conclusion. The study indicates that neither the demographic characteristics (age and gender) nor the clinical manifestations (presence and severity of subarachnoid hemorrhage) are statistically significantly associated with the localization of saccular cerebral aneurysms. These findings suggest that the location of SAs does not influence the clinical outcome or demographic distribution, highlighting the need for further research to understand the factors contributing to the rupture and clinical progression of saccular cerebral aneurysms.