{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:45:49Z","timestamp":1791492349711,"version":"4.3.4"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T00:00:00Z","timestamp":1647216000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The influence of preexisting factors on the clinical course of patients with subarachnoid hemorrhage (SAH), such as patient age, arterial hypertension, and aneurysm characteristics, is still a matter of debate. However, the specific impact of the exact aneurysm location has not received adequate attention. Therefore, the aim of this study was to investigate the influence of aneurysm location as a preexisting factor on the clinical course and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The data of consecutive patients with aneurysmal SAH who were treated from October 2010 to July 2020 were retrospectively analyzed. We distinguished four aneurysm locations: the anterior complex, internal carotid artery (ICA), middle cerebral artery (MCA), and posterior circulation. Logistic regression analysis and receiver operating characteristics were used to investigate the influence of aneurysm location on the occurrence of acute hydrocephalus, Delayed Cerebral Ischemia (DCI), neurological outcome, and in-hospital mortality. Neurological outcome was assessed 3 months after discharge using the Glasgow Outcome Scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 603 patients were included in this study. Patients with MCA aneurysms were 2.52 times less likely to develop acute hydrocephalus compared to patients with anterior complex aneurysms (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001). Delayed cerebral ischemia occurred most frequently in patients with an anterior complex aneurysm and least frequently in MCA aneurysms (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.014). In ICA aneurysms, mortality was 2.56-fold higher than in patients with aneurysms of the anterior complex (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.006). An additional ROC analysis showed a good prediction for in-hospital mortality when taking the aneurysm's location into account [AUC.855 (CI.817 \u22120.893)].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The aneurysm's location proved to be a significant predictor of acute hydrocephalus, DCI, and in-hospital mortality, demonstrating the impact of this preexisting biological factor on the course of SAH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2022.846066","type":"journal-article","created":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T02:35:35Z","timestamp":1647225335000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":25,"title":["Aneurysm Location Affects Clinical Course and Mortality in Patients With Subarachnoid Hemorrhage"],"prefix":"10.3389","volume":"13","author":[{"given":"Jennifer","family":"G\u00f6ttsche","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andras","family":"Piffko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias F.","family":"Pantel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manfred","family":"Westphal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lasse","family":"D\u00fchrsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Czorlich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Sauvigny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1016\/S1474-4422(09)70126-7","article-title":"Changes in case fatality of aneurysmal subarachnoid haemorrhage over time, according to age, sex, and region: a meta-analysis","volume":"8","author":"Nieuwkamp","year":"2009","journal-title":"Lancet Neurol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"135","DOI":"10.4103\/2152-7806.162676","article-title":"Systematic review of clinical prediction tools and prognostic factors in aneurysmal subarachnoid hemorrhage","volume":"6","author":"Lo","year":"2015","journal-title":"Surg Neurol Int."},{"key":"B3","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1097\/01.SMJ.0000051906.95830.1F","article-title":"Management of intracranial aneurysms: factors that influence clinical grade and surgical outcome","volume":"96","author":"Nanda","year":"2003","journal-title":"South Med J."},{"key":"B4","doi-asserted-by":"publisher","first-page":"j5745","DOI":"10.1136\/bmj.j5745","article-title":"Development and validation of outcome prediction models for aneurysmal subarachnoid haemorrhage: the SAHIT multinational cohort study","volume":"360","author":"Jaja","year":"2018","journal-title":"BMJ."},{"key":"B5","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1007\/s12028-014-9990-y","article-title":"The subarachnoid hemorrhage international trialists (SAHIT) repository: advancing clinical research in subarachnoid hemorrhage","volume":"21","author":"Jaja","year":"2014","journal-title":"Neurocrit Care."},{"key":"B6","doi-asserted-by":"publisher","first-page":"105124","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.105124","volume":"29","author":"Dharia","year":"2020","journal-title":"J Stroke Cerebrovasc Dis."},{"key":"B7","doi-asserted-by":"publisher","first-page":"791","DOI":"10.3171\/jns.1995.82.5.0791","article-title":"The poor prognosis of ruptured intracranial aneurysms of the posterior circulation","volume":"82","author":"Schievink","year":"1995","journal-title":"J Neurosurg."},{"key":"B8","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1159\/000324938","article-title":"Location and size of ruptured intracranial aneurysm and serious clinical outcomes early after subarachnoid hemorrhage: a population-based study in australasia","volume":"31","author":"Shiue","year":"2011","journal-title":"Cerebrovasc Dis."},{"key":"B9","doi-asserted-by":"publisher","first-page":"2391","DOI":"10.1161\/STROKEAHA.110.589275","article-title":"Definition of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage as an outcome event in clinical trials and observational studies: proposal of a multidisciplinary research group","volume":"41","author":"Vergouwen","year":"2010","journal-title":"Stroke."},{"key":"B10","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/s12028-015-0230-x","article-title":"Nimodipine dose reductions in the treatment of patients with aneurysmal subarachnoid hemorrhage","volume":"25","author":"Sandow","year":"2016","journal-title":"Neurocrit Care."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1914","DOI":"10.3171\/2018.1.JNS172715","article-title":"Clinical prediction of delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage","volume":"130","author":"Lee","year":"2019","journal-title":"J Neurosurg."},{"key":"B12","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/j.wneu.2016.04.086","article-title":"Aneurysm location as a prognostic outcome factor after subarachnoid hemorrhage from internal carotid artery aneurysms and potential impact for further experimental subarachnoid hemorrhage models","volume":"92","author":"Konczalla","year":"2016","journal-title":"World Neurosurg."},{"key":"B13","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1017\/S0317167100039160","article-title":"Acute hydrocephalus following aneurysmal subarachnoid hemorrhage","volume":"23","author":"Mehta","year":"1996","journal-title":"Can J Neurol Sci\/ J Can Des Sci Neurol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1007\/s12028-013-9952-9","article-title":"Risk stratification for the in-hospital mortality in subarachnoid hemorrhage: the HAIR score","volume":"21","author":"Lee","year":"2014","journal-title":"Neurocrit Care."},{"key":"B15","doi-asserted-by":"publisher","first-page":"4764","DOI":"10.1038\/s41598-020-61513-1","article-title":"Initial pupil status is a strong predictor for in-hospital mortality after aneurysmal subarachnoid hemorrhage","volume":"10","author":"Mader","year":"2020","journal-title":"Sci Rep."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1342","DOI":"10.1161\/01.STR.25.7.1342","article-title":"Initial and recurrent bleeding are the major causes of death following subarachnoid hemorrhage","volume":"25","author":"Broderick","year":"1994","journal-title":"Stroke."},{"key":"B17","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/S1474-4422(13)70263-1","article-title":"Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies","volume":"13","author":"Greving","year":"2014","journal-title":"Lancet Neurol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1159\/000487325","article-title":"Risk factors and clinical impact of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage: analysis from the china national stroke registry","volume":"50","author":"Duan","year":"2018","journal-title":"Neuroepidemiology."},{"key":"B19","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1038\/nrneurol.2013.246","article-title":"Delayed neurological deterioration after subarachnoid haemorrhage","volume":"10","author":"Macdonald","year":"2014","journal-title":"Nat Rev Neurol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"14","DOI":"10.3171\/jns.1968.28.1.0014","article-title":"Surgical risk as related to time of intervention in the repair of intracranial aneurysms","volume":"28","author":"Hunt","year":"1968","journal-title":"J Neurosurg."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1457","DOI":"10.1136\/jnnp.51.11.1457","article-title":"A universal subarachnoid hemorrhage scale: report of a committee of the world federation of neurosurgical societies","volume":"51","author":"Teasdale","year":"1988","journal-title":"J Neurol Neurosurg Psychiatry."},{"key":"B22","doi-asserted-by":"publisher","first-page":"e519","DOI":"10.1161\/STROKEAHA.110.581975","article-title":"Cognitive and functional outcome after aneurysmal subarachnoid hemorrhage","volume":"41","author":"Al-Khindi","year":"2010","journal-title":"Stroke."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1227\/01.NEU.0000246579.51572.6D","article-title":"Outcomes forsurgical and endovascularmanagement of intracranial aneurysmsusing a comprehensive grading system","volume":"59","author":"Ogilvy","year":"2006","journal-title":"Neurosurgery."},{"key":"B24","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1186\/s13054-015-1036-0","article-title":"Subarachnoid hemorrhage: who dies, and why?","volume":"19","author":"Lantigua","year":"2015","journal-title":"Crit Care."},{"key":"B25","doi-asserted-by":"publisher","first-page":"e0224013","DOI":"10.1371\/journal.pone.0224013","article-title":"Does aneurysm side influence the infarction side and patients' outcome after subarachnoid hemorrhage?","volume":"14","author":"Brawanski","year":"2019","journal-title":"PLoS ONE."},{"key":"B26","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1055\/s-2003-812500","article-title":"Factors leading to hydrocephalus after aneurysmal subarachnoid hemorrhage","volume":"46","author":"Demirgil","year":"2003","journal-title":"Minim Invasive Neurosurg."},{"key":"B27","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1212\/WNL.0000000000001891","article-title":"The unruptured intracranial aneurysm treatment score","volume":"85","author":"Etminan","year":"2015","journal-title":"Neurology."},{"key":"B28","doi-asserted-by":"publisher","first-page":"115","DOI":"10.3171\/2020.12.JNS203673","article-title":"Does intrathecal nicardipine for cerebral vasospasm following subarachnoid hemorrhage correlate with reduced delayed cerebral ischemia? A retrospective propensity score\u2013based analysis","volume":"136","author":"Sadan","year":"2022","journal-title":"J Neurosurg."},{"key":"B29","doi-asserted-by":"publisher","first-page":"CD000483","DOI":"10.1002\/14651858.CD000483.pub2","article-title":"Circulatory volume expansion therapy for aneurysmal subarachnoid haemorrhage","volume":"2004","author":"Rinkel","year":"2004","journal-title":"Cochrane Database Syst Rev"},{"key":"B30","doi-asserted-by":"publisher","first-page":"R23","DOI":"10.1186\/cc8886","article-title":"Effect of different components of triple-H therapy on cerebral perfusion in patients with aneurysmal subarachnoid haemorrhage: a systematic review","volume":"14","author":"Dankbaar","year":"2010","journal-title":"Crit Care."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2022.846066\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T02:35:36Z","timestamp":1647225336000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2022.846066\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,14]]},"references-count":30,"alternative-id":["10.3389\/fneur.2022.846066"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2022.846066","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,14]]},"article-number":"846066"}}