Ruslan Akhmedullin
Biography
Ruslan Akhmedullin, MPH. Currently employed as a Research and Teaching Assistant at Nazarbayev University School of Medicine in Astana, Kazakhstan. With a Master of Public Health degree, he contributes significantly to both research and education within the institution. My role involves supporting groundbreaking research initiatives and enhancing the learning experience for medical students.
Research Interest
My role involves supporting groundbreaking research initiatives and enhancing the learning experience for medical students.
Abstract
Intracranial Aneurysms and Delayed Cerebral Ischemia. Decades of Evidence on Unexplored Event.
Background: Delayed cerebral ischemia (DCI) following procedures on unruptured aneurysms are still rare, and its pathogenesis is unclear. Current literature reveals a female predominance among DCI cases, and speculates the fluctuations in sex-specific hormones as an explanation to disparity. Due to the scarcity of data, we aim to address the simple question: Do older females undergoing unruptured aneurysms treatment have higher chances for DCI? Methods: We conducted a literature search of the PubMed, Scopus, and Web of Science from 1980 to 2024. We identified studies on the evident DCI in patients who underwent treatment of unruptured aneurysms, and additionally provide another DCI case following a surgery in a patient with unruptured aneurysm. We pooled all the evidence and examined sex differences using Bayesian hierarchical models with 4 chains of 4000 Markov Chain Monte Carlo samples. Results: Of the 5,293 publications identified, 43 were selected for full-text review. 16 case series were eligible for inclusion, jointly spanning evidence over a forty-year period. Modelled DCI posterior mean odds ratio (OR) was 2.4 (0.4-17.8) and 0.4 (0.1-2.3) for females and males respectively, with posterior probabilities of 87% and 17%, respectively, for the OR exceeding 1.0. Conclusion: Our findings suggest females have substantially greater risk for DCI, which suggests a potential impact of the sex-specific hormonal variations, further justifying the observed predominance. In addition to long-standing hypotheses, we suspect a prolonged drying of exposed vessels to contribute to DCI onset.
