Distribución Topografica de Aneurismas Espontaneos Intracraneanos en Pacientes con Hemorragia Subaracnoidea en Uruguay. Estudio Multicéntrico

Introduction: The incidence of subarachnoid hemorrhage (SAH) in Uruguay is 8/100 thousand inhabitants per year. The most frequent cause of SAH is bleeding from a saccular aneurysm. The objective of this work is to describe the topographic distribution and characteristics of aneurysms in the population of Uruguay. Materials and Methods: It is a multicentric study. Information was collected from all the healthcare centers that diagnose and treat this pathology in Uruguay between July 2015 and June 2016, considering as sources of data: Hospital de Clinicas, Administration of the service estate (ASSE), centers of Neuro-interventionism (CEDIVA, CEN, IDITE), Ministry of the Interior, Service of Montevideo and Federetion Medic the Interior (FEMI). For the collection of data, were taken into account as diagnostic aneurysm study; arteriography and angio Tomography (angio CT). We analyzed all the aneurysms found by any of these 2 methods, including ruptured aneurysms and witnesses, of the saccular and fusiform type. Traumatic or mycotic aneurysms were not included. Results: 149 patients were analyzed. Among the ruptured aneurysms, 79% are divided into the previous communicant, the posterior communicator and those linked to the middle cerebral artery in the same proportion. Within the total number of aneurysms (ruptures and controls), the most frequent is that of the middle cerebral artery, although this percentage increases considerably if only aneurysms (48%) are taken into account. Between 7 and 20% of aneurysms are of posterior circulation, with which our report of 8% is in the lower limit of frequency. The frequency of multiple aneurysms is variable from 7% to 25% in the different series, being 26% in our series, with which we can say that in Uruguay there is a high frequency of multiple aneurysms. Conclusions: The topographic distribution of aneurysms in Uruguay is similar to the series published in the rest of the world, except for some exceptions such as: the high frequency of multiple aneurysms, the lower number of aneurysms of the posterior circulation, and in the cases of Bleeding from a middle cerebral, presenting multiple, is very frequent the presence of a middle cerebral artery aneurysm in a mirror.