Gender-Based Patterns in Intracranial Aneurysm Site and Rupture Risk: A Single-Center Retrospective Cohort Study from the Caucasus region

Abstract Background Intracranial aneurysms (IAs) are vascular abnormalities characterized by localized dilation of cerebral arteries, with a higher prevalence in females. Ruptured IAs can lead to subarachnoid hemorrhage, a life-threatening condition. The purpose of this study is to investigate gender-based differences in aneurysm distribution and rupture risk, focusing on the role of anatomical, hemodynamic, and hormonal factors. Results Among 164 patients, 85 were women (51.83%) and 79 were men (48.17%). The anterior communicating artery (ACA) was the most common site (34.76%), followed by the internal carotid artery (ICA) (30.49%) and middle cerebral artery (MCA) (18.29%). Women had a higher prevalence of ICA aneurysms (25.91% vs. 24.09%), while men showed a greater occurrence in the ACA (27.46% vs. 29.54%). Age-related differences were observed, with women experiencing ruptures at older ages. Conclusions Gender disparities in IA distribution highlight the influence of anatomical and hormonal factors. Women exhibit a higher prevalence in ICA aneurysms, whereas men are more affected in the ACA. These findings emphasize the need for sex-specific risk assessment, preventive strategies, and tailored clinical management. Future research should focus on predictive modeling for improved early detection and intervention.