Intracranial Aneurysm Rupture Is Predicted by Measures of Solar Activity

Objective The cause precipitating intracranial aneurysm rupture remains unknown in many cases. It has been observed that aneurysm ruptures are clustered in time, but the trigger mechanism remains obscure. Because solar activity has been associated with cardiovascular mortality and morbidity, we deci...

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Published in:World neurosurgery 2015-04, Vol.83 (4), p.588-595
Main Authors: Stienen, Martin N, Smoll, Nicolas R, Battaglia, Marina, Schatlo, Bawarjan, Woernle, Christoph M, Fung, Christian, Roethlisberger, Michel, Daniel, Roy Thomas, Fathi, Ali-Reza, Fandino, Javier, Hildebrandt, Gerhard, Schaller, Karl, Bijlenga, Philippe
Format: Article
Language:English
Subjects:
Aneurysm, Ruptured - complications
Aneurysm, Ruptured - epidemiology
Confidence Intervals
Databases, Factual
Female
Humans
Intracranial Aneurysm - complications
Intracranial Aneurysm - epidemiology
Male
Neurosurgery
Poisson Distribution
Regression Analysis
Solar Activity
Switzerland - epidemiology
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Summary:Objective The cause precipitating intracranial aneurysm rupture remains unknown in many cases. It has been observed that aneurysm ruptures are clustered in time, but the trigger mechanism remains obscure. Because solar activity has been associated with cardiovascular mortality and morbidity, we decided to study its association to aneurysm rupture in the Swiss population. Methods Patient data were extracted from the Swiss SOS database, at time of analysis covering 918 consecutive patients with angiography-proven aneurysmal subarachnoid hemorrhage treated at 7 Swiss neurovascular centers between January 1, 2009, and December 31, 2011. The daily rupture frequency (RF) was correlated to the absolute amount and the change in various parameters of interest representing continuous measurements of solar activity (radioflux [F10.7 index], solar proton flux, solar flare occurrence, planetary K-index/planetary A-index, Space Environment Services Center [SESC] sunspot number and sunspot area) using Poisson regression analysis. Results During the period of interest, there were 517 days without recorded aneurysm rupture. There were 398, 139, 27, 12, 1, and 1 days with 1, 2, 3, 4, 5, and 6 ruptures per day. Poisson regression analysis demonstrated a significant correlation of F10.7 index and RF (incidence rate ratio [IRR] = 1.006303; standard error (SE) 0.0013201; 95% confidence interval (CI) 1.003719−1.008894; P < 0.001), according to which every 1-unit increase of the F10.7 index increased the count for an aneurysm to rupture by 0.63%. A likewise statistically significant relationship of both the SESC sunspot number (IRR 1.003413; SE 0.0007913; 95% CI 1.001864−1.004965; P < 0.001) and the sunspot area (IRR 1.000419; SE 0.0000866; 95% CI 1.000249−1.000589; P < 0.001) emerged. All other variables analyzed showed no significant correlation with RF. Conclusions We found greater radioflux, SESC sunspot number, and sunspot area to be associated with an increased count of aneurysm rupture. The clinical meaningfulness of this statistical association must be interpreted carefully and future studies are warranted to rule out a type-1 error.
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2014.12.021