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(Stroke. 1999;30:1390-1395.)
© 1999 American Heart Association, Inc.
Original Contributions |
Prevalence of Intracranial Saccular Aneurysms in a Japanese Community Based on a Consecutive Autopsy Series During a 30-Year Observation Period
The Hisayama Study
From the Second Department of Internal Medicine (H.I., Y.K., M.F., I.K., K.N.) and the First (K.S.) and Second (M.T.) Departments of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Correspondence to Hiromitsu Iwamoto, MD, Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Maidashi 3-1-1, Higashi-Ku, Fukuoka, 812-8582 Japan.
Background and Purpose—Subarachnoid hemorrhage is a life-threatening disease that occurs mostly because of the rupture of intracranial saccular aneurysms. However, little is known about the prevalence of ruptured and unruptured aneurysms in the general population. The aim of the present study was to examine the prevalence of intracranial aneurysms on the basis of a consecutive autopsy series over a 30-year observation period in a general Japanese population in Hisayama.
Methods—We evaluated 1230 consecutive autopsy cases with craniotomy among the total deaths of Hisayama residents during 1962 through 1991 (overall autopsy rate, 80.1%).
Results—A total of 73 intracranial saccular aneurysms
were found in 57 cases (4.6%). The prevalence of aneurysms for
women was 2.4 times higher than that for men (7.1% versus 2.9%).
Among men, the prevalence of aneurysms remained unchanged
across the range of age groups. In contrast, there were 2 peaks in the
prevalence of aneurysms for women falling in the 40- to 49-year
(14.3%) and 60- to 69-year age groups (14.5%). The most common site
of the aneurysms was the middle cerebral artery (31.5%),
followed by the anterior communicating artery (30.1%), anterior
cerebral artery (15.1%), vertebrobasilar artery (12.3%), and internal
carotid artery (11.0%). Among these 73 aneurysms, 29 (39.7%)
were ruptured. Ruptured aneurysms were common in subjects <80
years of age, whereas unruptured aneurysms were prevalent in
those 
80 years of age. The frequency of ruptured aneurysms
was highest in the vertebrobasilar system (66.7%) and lowest in the
middle cerebral artery (13.0%).
Conclusions—Our data suggest that intracranial aneurysms are more frequent in women in the general Japanese population. Aneurysms are more prevalent in the middle cerebral artery, but the risk of rupture is highest in the vertebrobasilar system.
Key Words: aging • autopsy • cerebral aneurysm • cohort studies
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