{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:24:37Z","timestamp":1794324277810,"version":"4.9.0"},"reference-count":25,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,6]]},"abstract":"\n OBJECTIVE<\/jats:title>\n The aim of this study was to define predictive factors for rupture of middle cerebral artery (MCA) mirror bifurcation aneurysms.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n \n The authors retrospectively analyzed the data in patients with ruptured MCA bifurcation aneurysms with simultaneous presence of an unruptured MCA bifurcation mirror aneurysm treated in two neurosurgical centers. The following parameters were measured and analyzed with the statistical software R: neck, dome, and width of both MCA aneurysms\u2014including neck\/dome and width\/neck ratios, shape of the aneurysms (regular vs irregular), inflow angle of both MCA aneurysms, and the diameters of the bilateral A\n 1<\/jats:sub>\n and M\n 1<\/jats:sub>\n segments and the frontal and temporal M\n 2<\/jats:sub>\n trunks, as well as the bilateral diameter of the internal carotid artery (ICA).\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n The authors analyzed the data of 44 patients (15 male and 29 female, mean age 50.1 years). Starting from the usual significance level of 0.05, the Sidak-corrected significance level is 0.0039. The diameter of the measured vessels was statistically not significant, nor was the inflow angle. The size of the dome was highly significant (p = 0.0000069). The size of the neck (p = 0.0047940) and the width of the aneurysms (p = 0.0056902) were slightly nonsignificant at the stated significance level of 0.0039. The shape of the aneurysms was bilaterally identical in 22 cases (50%). In cases of asymmetrical presentation of the aneurysm shape, 19 (86.4%) ruptured aneurysms were irregular and 3 (13.6%) had a regular shape (p = 0.001).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n In this study the authors show that the extraaneurysmal flow dynamics in mirror aneurysms are nonsignificant, and the aneurysmal geometry also does not seem to play a role as a predictor for rupture. The only predictors for rupture were size and shape of the aneurysms. It seems as though under the same conditions, one of the two aneurysms suffers changes in its wall and starts growing in a more or less stochastic manner. Newer imaging methods should enable practitioners to see which aneurysm has an unstable wall, to predict the rupture risk. At the moment one can only conclude that in cases of MCA mirror aneurysms the larger one, with or without shape irregularities, is the unstable aneurysm and that this is the one that needs to be treated.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2017.2.jns162705","type":"journal-article","created":{"date-parts":[[2017,8,25]],"date-time":"2017-08-25T09:59:17Z","timestamp":1503655157000},"page":"1799-1807","source":"Crossref","is-referenced-by-count":18,"title":["Predictive anatomical factors for rupture in middle cerebral artery mirror bifurcation aneurysms"],"prefix":"10.3171","volume":"128","author":[{"given":"Homajoun","family":"Maslehaty","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University Hospital Essen;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crescenzo","family":"Capone","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital D\u00fcsseldorf;"},{"name":"Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine and Surgery, Universit\u00e0 degli Studi di Napoli \u201cFederico II,\u201d Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Frantsev","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital Essen;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Statistical Analysis Office, Bio-Statistics, University Hospital D\u00fcsseldorf, Germany; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramazan","family":"Jabbarli","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital Essen;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan F.","family":"Cornelius","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital D\u00fcsseldorf;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel A.","family":"Kamp","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital D\u00fcsseldorf;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Cappabianca","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine and Surgery, Universit\u00e0 degli Studi di Napoli \u201cFederico II,\u201d Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Sure","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital Essen;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Jakob","family":"Steiger","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital D\u00fcsseldorf;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios K.","family":"Petridis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital D\u00fcsseldorf;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1161\/STROKEAHA.108.532556","article-title":"Impact of monocyte chemoattractant protein-1 deficiency on cerebral aneurysm formation","volume":"40","author":"Aoki T","year":"2009","unstructured":"Aoki T, Kataoka H, Ishibashi R, Nozaki K, Egashira K, Hashimoto N: Impact of monocyte chemoattractant protein-1 deficiency on cerebral aneurysm formation. 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