Clinical characteristics and progression prediction of small unruptured anterior circulation intracranial aneurysms in female patients

ObjectiveThis study aims to summarize the clinical characteristics of small unruptured intracranial anterior circulation aneurysms in women and to investigate the risk factors influencing aneurysm progression.MethodsA retrospective analysis was conducted on 101 middle-aged female patients with intracranial aneurysms who were treated at Tongji Hospital,affiliated to Tongji Medical College of Huazhong University of Science and Technology,from January 2023 to May 2024. Data were collected on clinical symptoms,menopausal status, history of hypertension, blood pressure management, history of diabetes, cholesterol levels, blood homocysteine levels, as well as aneurysm size and location, anxiety, and family history of aneurysms. During the follow-up period,patients underwent magnetic resonance angiography (MRA) or computed tomography angiography (CTA) to monitor changes about intracranial aneurysms. A Cox regression model was used to analyze factors potentially affecting aneurysm progression or rupture and bleeding.ResultsIn this study, 59.4% (60 out of 101) of middle-aged women were found to have aneurysms located in the internal carotid artery segment, 18.8% (19 out of 101) in the middle cerebral artery segment, 9.9% (10 out of 101) in the anterior cerebral artery segment, 6.9% (7 out of 101) in the anterior communicating segment, and 5.0% (5 out of 101) in the posterior communicating artery segment. Among those with detected aneurysms, 54.5% (55 out of 101) experienced anxiety. Following a median follow-up period of 8 months (interquartile range: 4 to 16 months),30 patients exhibited aneurysm progression,corresponding to a progression rate of 29.7%. This included 28 patients with increased aneurysm volume and 2 patients who experienced ruptured bleeding. Analysis using a Cox regression model identified poor hypertension control (HR=3.955, 95% CI: 1.880-8.317, PHR=6.950, 95% CI: 2.417-19.987, PConclusionSmall intracranial aneurysms predominantly occur in the internal carotid artery segment in middle-aged female patients. Enhanced monitoring and management are recommended for patients with inadequate blood pressure control and those experiencing anxiety.