Potential triggering factors associated with aneurysmal subarachnoid hemorrhage: A large single-center retrospective study

Genetic evidence for the causal association of neuroticism with intracranial aneurysms: A Mendelian randomization study

OBJECTIVE

The aim of this study was to assess the potential causal relationship between neuroticism and 12 neuroticism items with intracranial aneurysms (IAs) and aneurysmal subarachnoid hemorrhage (aSAH) using a two-sample Mendelian randomization (MR) approach.

METHODS

Study data were obtained from the Genome-Wide Association Study (GWAS) pooled dataset, and we extracted summary statistics for neuroticism, 12 neuroticism items, and IAs, which were categorized into ruptured and unruptured aneurysms (IA), aSAH, and unruptured IAs (uIA). Single nucleotide polymorphisms (SNPs) were used as instrumental variables (IVs) to explore the causal relationship between exposure and outcome using five Mendelian randomization methods, with Inverse variance weighted (IVW) as the primary study method. Horizontal multiple validity tests, sensitivity analyses, and inverse MR ensured the stability of the results.

RESULTS

The two-sample MR showed a genetically predictive association between neuroticism and IA [odds ratio (OR) = 1.16; 95 % confidence interval (95 % CI): 1.04-1.30; p = 0.009], aSAH (OR = 1.17; 95 % CI: 1.03-1.33; p = 0.013) and uIA (OR = 1.30; 95 % CI: 1.07-1.59; p = 0.009) were all genetically predictive of association. Ivw showed a positive association between 5 neuroticism items and IA risk, 5 neuroticism items and aSAH risk as well as no genetically predictive association between neuroticism items and uIA. Sensitivity analysis and inverse MR confirmed the robustness of the results.

CONCLUSION

Our Mendelian randomization analysis demonstrated genetic causality between neuroticism and neuroticism items with intracranial aneurysms, aneurysmal subarachnoid hemorrhage, and unruptured intracranial aneurysms, and further studies are needed to confirm these results and explore potential mechanisms of action.

Clinical Characteristics as Predictors of Early and Delayed Cerebral Infarction in Aneurysmal Subarachnoid Hemorrhage Patients: A Meta-Analysis of 4527 Cases

BACKGROUND

Predictors of delayed cerebral infarction (DCI) and early cerebral infraction (ECI) among aneurysmal subarachnoid hemorrhage (aSAH) patients remain unclear. We aimed to systematically review and synthesize the literature on predictors of ECI and DCI among aSAH patients.

METHODS

We systematically searched PubMed, EMBASE, Cochrane Library, and Scopus databases comprehensively from inception through January 2024 for observational cohort studies examining predictors of DCI or ECI following aneurysmal SAH. Studies were screened, reviewed, and meta-analyzed, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Cochrane guidelines. The data were pooled as Odds ratios (OR) with 95% confidence intervals using Review Manager 5.4 software. Methodologic quality was assessed with the Newcastle-Ottawa Scale.

RESULTS

Our meta-analysis included 12 moderate to high-quality cohort studies comprising 4527 patients. Regarding DCI predictors, Higher severity scores (OR = 1.49, 95% confidence interval [1.12, 1.97], P = 0.005) and high Fisher scores (OR = 2.23, 95% confidence interval [1.28, 3.89], P = 0.005) on presentation were significantly associated with an increased risk of DCI. Also, the female sex and the presence of vasospasm were significantly associated with an increased risk of DCI (OR = 3.04, 95% confidence interval [1.35, 6.88], P = 0.007). In contrast, preexisting hypertension (P = 0.94), aneurysm treatment (P = 0.14), and location (P = 0.16) did not reliably predict DCI risk. Regarding ECI, the pooled analysis demonstrated no significant associations between sex (P = 0.51), pre-existing hypertension (P = 0.63), severity (P = 0.51), or anterior aneurysm location versus posterior (P = 0.86) and the occurrence of ECI.

CONCLUSION

Female sex, admission disease severity, presence of vasospasm and Fisher grading can predict DCI risk post-aSAH. Significant knowledge gaps exist for ECI predictors. Further large standardized cohorts are warranted to guide prognosis and interventions.

Effect of exercise-nutrition-psychology oriented nursing in patients undergoing interventional embolization for intracranial aneurysm

AIM

To investigate the effect of exercise-nutrition-psychology oriented nursing in patients underwent interventional embolization for intracranial aneurysm.

METHODS

In this retrospective study, 60 patients diagnosed with intracranial aneurysm who underwent interventional embolization between January 2021 and June 2023 at Yichun People's Hospital were included. Among them, 28 patients received routine nursing intervention (control group), and the other 32 patients received exercise-nutrition-psychology oriented nursing (observational group). Quality of life, psychological state, self-management capacity, postoperative complications, patient satisfaction and medication compliance were compared between the two groups.

RESULTS

The self-management ability scores in the observation group were higher than those of the control group after the intervention (P<0.05). The overall satisfaction rate in the observation group was higher than that of the control group (P<0.05). The SF-36 scores of patients (psychological function, physiological function, physical symptoms, and social function) in the observation group improved more significantly compared with those of the control group (P<0.05). Moreover, the total occurrence rate of postoperative complication in the observation group was lower than that in the control group (3.1% VS. 10.7%, P<0.05). The results of multivariate regression analysis showed that exercise-nutrition-psychology oriented nursing and postoperative complication were independent factors affecting the prognosis of patients who underwent interventional embolization for intracranial aneurysm.

CONCLUSIONS

Exercise-nutrition-psychology oriented nursing can improve patients' self-management ability and quality of life, reduce the risk of complications, and promote the recovery of the condition.

Association of aneurysmatic subarachnoid hemorrhage rate with environmental changes or emotional bursts

INTRODUCTION

In the present letter we share the results of an analysis of more than 140,000 non traumatic arterial subarachnoid hemorrhages whereas the majority of them is expected to be after aneurysm rupture, in which we investigate a possible correlation of climatic changes and emotional bursts as correlating factors for such a rupture.

METHODS

We obtained the daily number of SAH from 2006 to 2018 for males and females from the German National statistics agency. The ICD codes provided to us were I60.1-I60.7, which are SAHs originating from intracranial arteries and excluding traumatic SAH and other not specified SAH.

RESULTS

An increase of mean SAH per day could be seen in winter compared to summer and family events seemed to have a protective effect against aneurysmal SAH. Additionally 6.55 more women per day suffer an SAH compared to men.

CONCLUSION

There is a statistical significant higher risk of aneurysm ruptures in winter and in females, and a statistical lower number in Mother's day.