Aneurysms of the anterior and posterior cerebral circulation: comparison of the morphometric features

Acta Neurochir (Wien). 2014 Sep;156(9):1647-54. doi: 10.1007/s00701-014-2173-y. Epub 2014 Jul 19.


Background: Intracranial aneurysms (IAs) located in the posterior circulation are considered to have higher annual bleed rates than those in the anterior circulation. The aim of the study was to compare the morphometric factors differentiating between IAs located in the anterior and posterior cerebral circulation.

Methods: A total number of 254 IAs diagnosed between 2009 and 2012 were retrospectively analyzed. All patients qualified for diagnostic, three-dimensional rotational angiography. IAs were assigned to either the anterior or posterior cerebral circulation subsets for the analysis. Means were compared with a t-test. The univariate and stepwise logistic regression analyses were used to determine the predictors of morphometric differences between the groups. For the defined predictors, ROC (receiver-operating characteristic) curves and interactive dot diagrams were calculated with the cutoff values of the morphometric factors.

Results: The number of anterior cerebral circulation IAs was 179 (70.5 %); 141 (55.5 %) aneurysms were ruptured. Significant differences between anterior and posterior circulation IAs were found for: the parent artery size (5.08 ± 1.8 mm vs. 3.95 ± 1.5 mm; p < 0.05), size ratio (2.22 ± 0.9 vs. 3.19 ± 1.8; p < 0.045) and aspect ratio (AR) (1.91 ± 0.8 vs. 2.75 ± 1.8; p = 0.02). Predicting factors differentiating anterior and posterior circulation IAs were: the AR (OR = 2.20; 95 % CI 1.80-270; Is 270 correct or should it be 2.70 and parent artery size (OR = 0.44; 95 % CI 0.38-0.54). The cutoff point in the ROC curve was 2.185 for the AR and 4.89 mm for parent artery size.

Conclusions: Aspect ratio and parent artery size were found to be predictive morphometric factors in differentiating between anterior and posterior cerebral IAs.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aneurysm, Ruptured / diagnostic imaging*
  • Cerebral Angiography*
  • Cerebrovascular Circulation
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted*
  • Imaging, Three-Dimensional*
  • Intracranial Aneurysm / diagnostic imaging*
  • Male
  • Middle Aged
  • ROC Curve
  • Retrospective Studies
  • Risk Factors