Presentation, management and outcomes of ruptured intracranial aneurysms in Africa: A systematic review and meta-analysis

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-01-17 DOI:10.1016/j.jocn.2025.111054

Kwadwo Darko , Grace Simmons , W. Elorm Yevudza Jr. , Pearl Tenkorang , Bernice Limann , Chibueze Agwu , Simon Sackitey , Ruth Agyekum , Peace Odiase , Nana K. Darko , Mina Guirguis , Umaru Barrie , Salah G. Aoun , Mabel Banson , Teddy Totimeh

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引用次数: 0

Abstract

Background

Approximately two percent of the world’s population are affected by intracranial aneurysms (IAs). This study aimed to evaluate literature regarding presentation, treatment and outcomes of ruptured IAs in Africa.

Methods

A systematic review of the literature using PubMed/MEDLINE, SCOPUS, Web of Science and Google Scholar databases was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results

Twenty-one retrospective studies with 1,109 patients and 11 case reports (10 countries) were included. The mean Methodological Index for Nonrandomized Studies (MINORS) for included articles was 9.1 ± 2.5. The mean age was 43.3 years (95 %CI: 37.8–48.8), with 58.4 % (342/586) female patients. WFNS/H&H grade 1 was reported in 41.2 % (98/238) of cases and Fischer grade 2 was reported in 30.4 % (98/322) of cases. CT angiography was utilized in 94.6 % (560/592, 12 articles). The ICA was reported in 24.5 % of cases (CI: 12.9 %-36.1 %). AComA and MCA were affected in 21.2 % (95 %CI: 15.2–27.2 %) and 21.3 % (95 %CI: 15.2–27.2 %) of cases, respectively. The odds of ruptured aneurysms in the anterior circulation were 14.3 (CI: 6.3–32.2). Surgical clipping was reported in 75.0 % (448/597) and coiling in 20.4 % (122/597) across 13 studies. 66.8 % (95 %CI: 57.4–76.3 %) of patients experienced neurological improvement with a mortality rate of 12.3 % (95 %CI: 7.5–17.1 %) at last follow-up.

Conclusion

Ruptured IAs are small and located in the anterior circulation. The lack of detailed aneurysm size reporting hampers the identification of a critical rupture size for management. More research is needed to understand aneurysm characteristics and predictors of rupture in Africa.

查看原文本刊更多论文

非洲颅内动脉瘤破裂的表现、处理和结果：系统回顾和荟萃分析。

背景：大约2%的世界人口受到颅内动脉瘤（IAs）的影响。本研究旨在评估有关非洲IAs破裂的表现、治疗和结果的文献。方法：采用PubMed/MEDLINE、SCOPUS、Web of Science和b谷歌Scholar数据库，按照PRISMA （Preferred Reporting Items for systematic Reviews and meta - analysis）指南对相关文献进行系统综述。结果：纳入21项回顾性研究，1109例患者和11例病例报告（10个国家）。纳入文章的非随机研究（未成年人）的平均方法学指数为9.1±2.5。平均年龄43.3岁（95% CI: 37.8-48.8），女性患者占58.4%（342/586）。WFNS/H&H 1级占41.2% (98/238)，Fischer 2级占30.4%（98/322）。CT血管造影占94.6%（560/ 592,12篇）。24.5%的病例报告有ICA （CI: 12.9% - 36.1%）。AComA和MCA分别有21.2% （95% CI: 15.2- 27.2%）和21.3% （95% CI: 15.2- 27.2%）的病例受到影响。前循环动脉瘤破裂的几率为14.3 （CI: 6.3-32.2）。在13项研究中，手术夹持的发生率为75.0%(448/597)，卷取的发生率为20.4%（122/597）。最后一次随访时，66.8% （95% CI: 57.4- 76.3%）的患者神经系统改善，死亡率为12.3% （95% CI: 7.5- 17.1%）。结论：破裂的IAs小且位于前循环。缺乏详细的动脉瘤大小报告阻碍了对关键破裂尺寸的识别。需要更多的研究来了解非洲动脉瘤的特征和破裂的预测因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.