The impact of the number of aneurysms on the course of the acute period of subarachnoid hemorrhage in patients with multiple intracranial aneurysms

Objective to determine the effect of the number of multiple intracranial aneurysms (MIA) on the course of the acute period of subarachnoid hemorrhage (SAH). Materials and methods: A cross-sectional retrospective study was conducted involving 92 patients in the acute phase of SAH due to the rupture of MIA. Patients were divided into two groups depending on the number of aneurysms. Demographic indicators (age, gender) and clinical-instrumental factors (comorbidities, extent of hemorrhage, severity at admission, clinical manifestations), treatment characteristics, and outcomes were analyzed using descriptive statistics and logistic regression. Results: Comorbidities were 3.4 times more common among patients with three or more aneurysms (p=0.143). Patients in group 2 were 1.9 times more likely to be admitted with a World Federation of Neurosurgical Societies (WFNS) grade 2 (p=0.335). WFNS grade 3 at admission was observed twice as often in group 1 (p=0.447). Patients from group 1 and group 2 were equally likely to present with WFNS grade 4 (p=0.978). The probability of being admitted with a WFNS grade 5 was 1.8 times higher in group 2 (p=0.830). The presence of meningeal syndrome increased the risk of having 3 or more aneurysms by more than four times (OR 4.41, CI 0.41-47.13, p=0.21). The presence of motor impairments significantly reduced the risk of having 3 or more aneurysms (OR 0.63, CI 0.09-4.18, p=0.63). Patients in group 2 were slightly more likely to develop vasospasm than those in group 1 (OR 1.22, CI 0.34-4.31, p=0.752). The presence of comorbidities increased with the number of aneurysms (OR 3.42, CI 0.65-17.62, p=0.143). Conclusions: The presence of comorbidities more than triples the chances of having 3 or more aneurysms. Patients with fewer aneurysms are twice as likely to be admitted in a milder condition (WFNS grade 2). The probability of severe condition (WFNS grade 5) at hospital admission for patients in group 2 is 1.8 times higher than in group 1. The likelihood of motor disorders decreases by 4.4 times with an increasing number of aneurysms. The probability of vasospasm development slightly increased with the number of aneurysms. These data emphasize the importance of a comprehensive approach to the assessment of SAH patients and the need for careful monitoring of patients at high risk of vasospasm.