Evidence map›Paper›PMID 41661032›Full record

SynthesisEuropean stroke journal2026

Risk factors for saccular unruptured intracranial aneurysms: a systematic review and meta-analysis.

Maaike J A van Eldik, Mariam Ali, Stijn Rietkerken, Jan W Schoones, Sanne A E Peters, Hester M den Ruijter, Ynte M Ruigrok

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in European stroke journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Maaike J A van EldikDepartment of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Mariam AliDepartment of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
Stijn RietkerkenDepartment of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Jan W SchoonesDirectorate of Research and Valorisation, Leiden University Medical Center, Leiden, The Netherlands.
Sanne A E PetersJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Hester M den RuijterLaboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.ORCID 0000-0001-9762-014X
Ynte M RuigrokDepartment of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

Funding

Dutch Heart Foundation Dekker grant 03-001-2022-0157Dutch Organization for Health Research and Development 09150172010050European Research Council under the European Union's Horizon 2020 research and innovation program grant agreement 852173VIDI Fellowship
6 · The paper itself

Abstract

introductionIntracranial aneurysms are often unruptured and two-thirds of patients with unruptured intracranial aneurysms (UIAs) are women. Rupture of an intracranial aneurysm causes aneurysmal subarachnoid haemorrhage (aSAH). While risk factors for aSAH have been extensively studied, those for UIA remain less well understood. We performed a systematic review and meta-analysis to identify risk factors for the presence of saccular UIAs and assess potential sex differences. PATIENTS AND

methodsWe conducted a systematic review and meta-analysis of cohort, case-control, and cross-sectional studies on risk factors for UIA up to March 2024. Assessed risk factors included smoking, hypertension, alcohol use, diabetes, hypercholesterolaemia, physical activity, and body mass index. We performed random-effects meta-analyses to calculate pooled odds ratios (ORs) and 95% CIs for each risk factor.

resultsWe identified 21 studies reporting on overall 347 907 participants and 8698 UIA cases. Hypertension (OR 1.72, 95% CI, 1.42-2.09) and smoking (OR 1.47, 95% CI, 1.11-1.95) were associated with the presence of UIAs. No statistically significant associations were found for the other assessed risk factors. Among 18 studies that included both sexes, only one provided sex-stratified results, preventing us from assessing potential sex differences. DISCUSSION: Future research should consistently report sex-stratified results to enable investigation of potential sex differences in UIA risk factors and further explore female-specific risk factors that may contribute to the high female preponderance in UIA.

conclusionHypertension and smoking are associated with an increased risk of UIAs. The lack of sex-stratified data limits conclusions about sex-specific risk profiles.

Indexed as

Intracranial AneurysmAlcohol DrinkingFemaleHumansHypertensionMaleRisk FactorsSex FactorsSmokingmeta-analysisrisk factorsystematic reviewunruptured intracranial aneurysm

Identifiers

PMID41661032
PMCPMC12884560

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.