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Abstract Details

Aneurysmal subarachnoid hemorrhage: frequency and clinical evolution according to aneurysmal size
Cerebrovascular Disease and Interventional Neurology
P13 - Poster Session 13 (5:30 PM-6:30 PM)
4-009
To report the frequency and clinical evolution of aSAH secondary to ruptured aneurysms <7mm. To compare these variables with aSAH secondary to ruptured aneurysms ≥7mm.
Size is the main predictor of aneurysmal rupture.The treatment of aneurysms <7mm is controversial. Despite recent studies suggesting a significant proportion of aSAH from aneurysms <7mm, the clinical data of these patients remain largely unexplored.
We included patients >18 years with aSAH admitted to a referral center between 2012-2019. Electronic medical records were retrospectively reviewed to collect demographics, clinical presentation, complications and outcomes. Patients were divided according to size of the ruptured aneurysm (<7mm and ≥7mm) for comparison. Continuous variables were presented as median (interquartile range, IQR) and categorical as proportions. Differences between groups were assessed using the Mann-Whitney, chi-square or Fisher's exact tests, depending on the case. A p value <0.05 was considered significant.

Among 54 aSAH patients, 29(54%) had ruptured aneurysms <7mm. Rebleeding (8%vs.3%;p=0.89) and requirement of external ventricular drain (32%vs.17%;p=0.34) were more frequent in patients with aneurysms ≥7mm. Patients with aneurysms <7mm had a trend towards development of sonographic vasospasm (78%vs.68%) and delayed cerebral ischemia (24%vs.16%). Patients with aneurysms ≥7mm had worse functional outcomes at discharge (median NIHSS 2 vs. 0 (p=0.032) and mRS<3 64% vs. 89,7% (p=0,053)).
Half of patients with aSAH in this series bled from aneurysms <7mm. This group had a non-significant trend towards development of sonographic vasospasm and delayed cerebral ischemia. However, they had better functional outcomes at discharge. These data challenge the classic concept of clinical observation in patients with non-ruptured cerebral aneurysms <7mm. Prospective studies in larger populations are warranted to confirm these findings.
Authors/Disclosures
Mario E. Ricciardi, Sr., MD (Fleni)
PRESENTER 		Dr. Ricciardi has nothing to disclose.
Maximiliano A. Hawkes, MD (Mayo Clinic) Dr. Hawkes has or had stock in Navinetics-AI.
Julian Acosta, MD (Yale) Dr. Acosta has nothing to disclose.
Sebastian F. Ameriso, MD Dr. Ameriso has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for PHRI. Dr. Ameriso has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Bayer, Boehringer, Abbott, AstraZeneca.