Concurrent Intracranial and Thoracic Aortic Aneurysms

The pathogeneses of both thoracic aortic aneurysm (TAA) and intracranial aneurysm (ICA) share common pathologic mediators. However, the prevalence of ICA in patients with TAA is not known. The present study investigated the prevalence of concurrent ICA to determine whether patients with TAA should be screened for ICA. The records of 212 patients with TAA and concurrent brain images (computed tomographic angiograms or magnetic resonance angiograms) were retrospectively analyzed. A bivariate statistical analysis (Fisher's exact test) was used to compare the subgroups. We found that patients with TAA had a 9.0% prevalence of ICA (19 of 212 patients), ninefold greater than that in the general population. Also, the location of the TAA influenced the prevalence of ICA. The prevalence of ICA in patients with a descending TAA was significantly greater—33% (5 of 15 patients)—than the prevalence (7.1%) in patients (14 of 197 patients) with an ascending TAA (p = 0.006). Hypertension also increased the prevalence of concurrent ICA: 18 (11.8%) of 153 patients with hypertension and a TAA had concurrent ICA, but only 1 (1.7%) of 59 normotensive patients with a TAA had an ICA (p = 0.03). A history of cigarette smoking increased the risk of an ICA. Race, age, and gender did not significantly affect the prevalence of concurrent ICA. In conclusion, patients with a TAA are at increased risk of having an ICA. We suggest that patients with a TAA be screened for an ICA.