Posterior Circulation Aneurysmal Subarachnoid Hemorrhage: A Comparison Between Saccular and Dissecting Aneurysms.

Authors

Jian Li, Guoqiang Song, Guijing Liu, Yunyi Tong, Xinmiao Gu, Bangyue Wang, Libin Fan, Letian Li, Xinyu Yang, Honglei Liang, Xiaojun Zhang

Published in

Brain and behavior. Volume 16. Issue 9. Pages e71668.

Abstract

There is a lack of comparative studies between posterior circulation saccular aneurysms (SA) and dissecting aneurysms (DA). This study aims to comprehensively compare the clinical characteristics, treatment strategies, and outcomes of SA and DA.
We included all consecutive patients with posterior circulation aneurysmal subarachnoid hemorrhage (aSAH) who underwent surgical treatment between January 2017 and December 2020 from the Chinese Multicenter Cerebral Aneurysm Database (CMAD). Baseline data were retrospectively collected, and survival status and 2-year mRS scores were prospectively assessed. Functional outcomes were categorized as favorable (mRS 0-2) and unfavorable (mRS 3-6). Logistic regression models were used to explore the association between aneurysm morphology and outcomes.
Note that 406 patients with posterior circulation aSAH who underwent surgical treatment were included, comprising 314 (77.3%) with SA and 92 (22.7%) with DA. In unadjusted analyses, DA was associated with a lower rate of unfavorable outcomes at 2 years (17.1% vs. 34.8%, p = 0.003) but a higher rate of parent vessel sacrifice (22.8% vs. 8.0%, p < 0.001), while ischemic complications were comparable between groups. After further adjustment for covariates, DA showed a trend toward a lower risk of unfavorable outcomes in Model 3 (OR = 0.490, 95% CI 0.237-1.013, p = 0.054). In addition, the association between DA and a higher risk of parent vessel sacrifice remained consistent across all models (Model 1: OR = 3.419, 95% CI 1.811-6.456, p < 0.001; Model 2: OR = 2.737, 95% CI 1.415-5.293, p = 0.003; Model 3: OR = 2.899, 95% CI 1.463-5.747, p = 0.002).
DA may be associated with a trend toward better long-term functional outcomes compared with SA. Although parent vessel sacrifice was more frequently required, it was not associated with an increased risk of ischemic complications.

PMID:
42706767
Bibliographic data and abstract were imported from PubMed on 08 Sep 2026.

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