Abstract 104: Fusiform intracranial aneurysms wall enhancement correlates with mass effect and symptomatic presentation

E Sagues Sese; C Dier; N Shenoy; A Gudino; M Cabarique; E Samaniego

doi:10.1161/SVIN.04.suppl_1.104

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Abstract 104: Fusiform intracranial aneurysms wall enhancement correlates with mass effect and symptomatic presentation

E Sagues Sese, C Dier, N Shenoy, A Gudino, M Cabarique and E Samaniego

Stroke: vascular and interventional neurology, Vol.4(S1)

11/01/2024

DOI: 10.1161/SVIN.04.suppl_1.104

PMCID: PMC12773927

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Abstract

BackgroundIntracranial aneurysms can cause symptoms due to brain parenchyma compression. It is unclear why some aneurysms may cause symptoms due to mass effect. Hence, recognizing symptoms from mass effect caused by these aneurysms based on their location and angiographic features may help in the triage of aneurysms for treatment vs observation. Our goal is to investigate the relationship between fusiform aneurysms’ mass effect, aneurysm wall enhancement (AWE) distribution, and symptomatic presentation.Material and methodsPatients were scanned using a 3T high‐resolution (HR)‐MRI protocol. Symptoms included sentinel headaches, mild headaches, dizziness, and cranial nerve palsy. Brain parenchyma mass effect was identified by analyzing MRI changes on T1 and FLAIR sequences. A 3D‐Mapping AWE pipeline measured the signal distribution across the aneurysm wall. 3D heatmaps were aligned with the HR‐MRI images to assess aneurysm wall enhancement in areas causing mass effect.ResultsForty‐eight intracranial fusiform aneurysms were included. Mass effect was present in 16/21 symptomatic aneurysms (76%) and in 22/27 (81%) asymptomatic aneurysms. Mass effect was present in a higher proportion of patients reporting cranial nerve palsy and dizziness, compared to mild and sentinel headaches (83% and 100% vs 40% and 50%, respectively). The median T1Gd AWE was higher in symptomatic compared to asymptomatic patients (0.98, IRQ=0.29 vs 0.91, IQR=0.35, p=0.216, figure).ConclusionSymptomatic fusiform aneurysms with mass effect exhibit more AWE. This can be a potential biomarker of fusiform aneurysms that may become symptomatic.

Headaches

Neurological Disorders

Aneurysms

Asymptomatic

Details

Title: Subtitle: Abstract 104: Fusiform intracranial aneurysms wall enhancement correlates with mass effect and symptomatic presentation
Creators: E Sagues Sese
C Dier
N Shenoy
A Gudino
M Cabarique
E Samaniego
Resource Type: Abstract
Publication Details: Stroke: vascular and interventional neurology, Vol.4(S1)
DOI: 10.1161/SVIN.04.suppl_1.104
PMCID: PMC12773927
ISSN: 2694-5746
eISSN: 2694-5746
Publisher: Wiley Subscription Services, Inc
Language: English
Date published: 11/01/2024
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984740956702771

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