scholarly journals MR angiography and surgery for unruptured familial intracranial aneurysms in persons with a family history of cerebral aneurysms.

1999 ◽  
Vol 173 (1) ◽  
pp. 133-138 ◽  
Author(s):  
B M Brown ◽  
F Soldevilla
Keyword(s):  
Family History ◽  
Intracranial Aneurysms ◽  
Mr Angiography ◽  
Cerebral Aneurysms ◽  
History Of

scholarly journals Is there an inherited anatomical conformation favoring aneurysmal formation of the anterior communicating artery?

2017 ◽  
Vol 126 (5) ◽  
pp. 1598-1605 ◽  
Author(s):  
Romain Bourcier ◽  
Cédric Lenoble ◽  
Béatrice Guyomarch-Delasalle ◽  
Benjamin Daumas-Duport ◽  
Chrysanthi Papagiannaki ◽  
...  
Keyword(s):  
Family History ◽  
Intracranial Aneurysms ◽  
Mr Angiography ◽  
Anatomical Variations ◽  
3D Models ◽  
Contralateral Side ◽  
Current Evidence ◽  
Anterior Communicating Artery ◽  
History Of ◽  
Hereditary Character

OBJECTIVEThe pathophysiological mechanisms responsible for the formation of intracranial aneurysms (IAs) remain only partially elucidated. However, current evidence suggests a genetic component. The purpose of this study was to investigate the specific anatomical variations in the arterial complex that are associated with the presence of anterior communicating artery (ACoA) aneurysms in the familial forms of IAs.METHODSThis multicenter study investigated bifurcation IAs in patients who had a sporadic ACoA IA without a family history of IA (SACAA group), in patients who had an ACoA IA with a family history of IA (FACAA group), and in their healthy first-degree relatives (HFDRs). Through the use of MR angiography (MRA) reconstructions, the symmetry of the A1 segments and the angle between the A1 and A2 segments were analyzed on 3D models for each group. These measurements were then compared among the 3 groups.RESULTSTwenty-four patients with SACAA, 24 patients with FACAA, and 20 HFDRs were included in the study. Asymmetrical configuration of the A1 segments was more frequent in the FACAA group than in the HFDR group (p = 0.002). The aneurysm-side A1–A2 angle was lower in the FACAA group (p = 0.003) and SACAA group (p = 0.007) than in the HFDR group. On the contralateral side, there was no difference in A1–A2 angles between groups.CONCLUSIONSThe anatomical shape of the ACoA complex seems to be similarly associated with the presence of ACoA IAs in both the FACAA and SACAA groups. This highlights the role played by hemodynamic constraints in aneurysm formation and questions the hypothesis of the hereditary character of these anatomical shapes.

Current implications for the efficacy of noninvasive screening for occult intracranial aneurysms in patients with a family history of aneurysms

1995 ◽  
Vol 83 (1) ◽  
pp. 42-49 ◽  
Author(s):  
Nancy A. Obuchowski ◽  
Michael T. Modic ◽  
Michele Magdinec
Keyword(s):  
Family History ◽  
Natural History ◽  
Life Expectancy ◽  
Intracranial Aneurysms ◽  
Positive Family History ◽  
Aneurysm Rupture ◽  
Average Life Expectancy ◽  
Content Type ◽  
Rupture Rate ◽  
History Of

✓ Although the technology exists for accurate noninvasive screening for intracranial aneurysms, the efficacy of screening depends on several key parameters of the natural history of aneurysms. Recent studies suggest that the prevalence of intracranial aneurysms may reach 20% in the subpopulation of patients with a family history of these lesions; other key parameters are less certain. The authors investigated factors that impact the efficacy of screening to establish interim guidelines. Three plausible models for the natural history of aneurysms were constructed. For each model the monetary cost of screening and the average gain in life expectancy were computed for a range of screening ages and prevalence rates. It is shown that the efficacy of screening depends on the pattern of aneurysm rupture. If aneurysms develop and rupture rapidly, then screening has no benefit. On the other hand, if aneurysms remain at risk for some time after formation, then screening may improve average life expectancy depending on when it occurs. The authors recommend that patients with a positive family history of aneurysms who are 30 years of age or younger be screened. This recommendation is based on the belief that the gains attributable to screening, assuming a constant rupture rate, outweigh the losses attributable to screening using a decreasing rupture rate model.

scholarly journals Demographic, Clinical, and Radiographic Characteristics of Cerebral Aneurysms in Tuberous Sclerosis Complex

2020 ◽  
Author(s):  
Mehdi Chihi ◽  
Ulrich Sure ◽  
Ramazan Jabbarli
Keyword(s):  
Systematic Review ◽  
Magnetic Resonance ◽  
Tuberous Sclerosis ◽  
Tuberous Sclerosis Complex ◽  
Intracranial Aneurysms ◽  
Mr Angiography ◽  
Cerebral Aneurysms ◽  
Consensus Conference ◽  
Current Evidence ◽  
Recent Systematic Review

To date, little is known on the prevalence, incidence, and characteristics of intracranial aneurysms (IA) in patients with tuberous sclerosis complex (TSC). Based on our recent systematic review and two cases treated in our institute, we summarize the current evidence concerning the distinct characteristics of these aneurysms. In contrast to saccular IA in healthy adults, IA in TSC present commonly with large or even giant sac size and fusiform configuration, location predilection on the internal carotid artery remote from the branching zones, remarkable higher prevalence of pediatric cases, inverted sex-ratio, and suspected rapid growth. Although the pathogenesis of IA in TSC is still unclear, all these features might point to the crucial role a congenital defect in the development of IA rather than extrinsic or environmental factors. Furthermore, we discuss the enhancement of the regular magnetic resonance (MR) imaging screening suggested by the last recommendations of the 2012 International TSC Consensus Conference with cranial time-of-flight MR angiography in order to enable timely identification and treatment of frequently complex IA in TSC.

Hemodynamics and the Natural History of Cerebral Aneurysms

2007 ◽  
Author(s):  
Juan R. Cebral ◽  
Marcelo A. Castro ◽  
Christopher M. Putman
Keyword(s):  
Shear Stress ◽  
Natural History ◽  
Wall Shear Stress ◽  
Intracranial Aneurysms ◽  
Cerebral Aneurysms ◽  
Patient Specific ◽  
High Wall Shear Stress ◽  
Arterial Hemodynamics ◽  
History Of ◽  
Major Factors

The mechanisms responsible for the evolution and rupture of cerebral aneurysms are not well understood. This is a multi-factorial problem, and previous studies [1–3] have identified the major factors involved: a) arterial hemodynamics, b) mechanobiology and wall biomechanics, and c) peri-aneurysmal environment. In this paper we present recent results based on patient-specific computational hemodynamics models of a number of cerebral aneurysms that indicate that hemodynamics plays an important role both in the progression and rupture of intracranial aneurysms. In particular, the data seems to support the idea that mechanisms associated to high wall shear stress may be responsible for the evolution and rupture of these aneurysms [4].

Familial Predisposition and Differences in Radiographic Patterns in Spontaneous Nonaneurysmal Subarachnoid Hemorrhage

Neurosurgery ◽  
2020 ◽  
Author(s):  
Pui Man Rosalind Lai ◽  
Isaac Ng ◽  
William B Gormley ◽  
Nirav J Patel ◽  
Kai U Frerichs ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Family History ◽  
Clinical Outcome ◽  
Intracranial Aneurysms ◽  
High Rate ◽  
Study Patient ◽  
Familial Predisposition ◽  
History Of ◽  
Nonaneurysmal Subarachnoid Hemorrhage ◽  
Patient Presentation

Abstract BACKGROUND Subarachnoid hemorrhage (SAH) from an intracranial aneurysmal rupture is the most common nontraumatic etiology for SAH, but up to 15% of patients with SAH have no identifiable source. OBJECTIVE To assess familial predisposition to spontaneous nonaneurysmal SAH (naSAH) and to evaluate whether family history affects the severity of presentation and prognosis of this condition. METHODS We conducted a retrospective analysis of all spontaneous SAH with negative digital subtraction angiography from 2004 to 2018. Patients were divided into 2 groups: patients with first- or second-degree relatives with intracranial aneurysms and patients with no family history. Univariate and multivariate regression analyses were used to study patient presentation, radiographic patterns of hemorrhage, and clinical outcome. RESULTS A total of 100 patients met the inclusion criteria. There were no individuals with family history of naSAH. A total of 15 patients (15%) had at least one family member with an intracranial aneurysm, of which 12 (12%) presented as SAH. Patients without family history had a higher percentage of perimesencephalic presentation, whereas those with family history had a higher percentage of nonperimesencephalic SAH presentation (47% vs 13%, odds ratio [OR] 0.17 [95% CI 0.04, 0.81]). CONCLUSION We found a high rate of family history of intracranial aneurysms in patients who presented with naSAH. Although there was no difference in clinical outcome in patients with and without family history, there appears to be a higher percentage of nonperimesencephalic radiographic patterns of SAH in those with family history, suggesting possible different etiologies of these hemorrhages.

Risk factors for the formation of multiple intracranial aneurysms

2001 ◽  
Vol 94 (5) ◽  
pp. 728-732 ◽  
Author(s):  
Habib E. Ellamushi ◽  
Joan P. Grieve ◽  
H. Rolf Jäger ◽  
Neil D. Kitchen
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Cigarette Smoking ◽  
Cerebrovascular Disease ◽  
Intracranial Aneurysms ◽  
Content Type ◽  
Multiple Aneurysms ◽  
Female Patients ◽  
History Of ◽  
Fine Print

Object. Several factors are known to increase the risk of subarachnoid hemorrhage (SAH) and spontaneous intracerebral hematoma. However, information on the roles of these same factors in the formation of multiple aneurysms is less well defined. The purpose of this study was to examine factors associated with an increased risk of multiple aneurysm formation. Methods. A retrospective review of the medical records of all patients with a diagnosis of SAH and intracranial aneurysms who were admitted to a single institution between 1985 and 1997 was undertaken. The authors examined associations between risk factors (patient age and sex, menopausal state of female patients, hypertension, cigarette smoking, alcohol consumption, history of cardiovascular disease or diabetes mellitus, and family history of cerebrovascular disease) and the presence of multiple aneurysms by using the Fisher exact test and logistic regression analysis. Of 400 patients admitted with a diagnosis of cerebral aneurysms, 392 were included in the study (287 women and 105 men). Two hundred eighty-four patients harbored a single aneurysm and 108 harbored multiple aneurysms (2 aneurysms in 68 patients, three aneurysms in 22 patients, four aneurysms in 13 patients, and five aneurysms in five patients). Conclusions. Statistical analysis revealed that, as opposed to the occurrence of a single aneurysm, there was a significant association between the presence of multiple aneurysms and hypertension (p < 0.001), cigarette smoking (p < 0.001), family history of cerebrovascular disease (p < 0.001), female sex (p < 0.001), and postmenopausal state in female patients (p < 0.001).

Intrinsic, Transitional, and Extrinsic Morphological Factors Associated With Rupture of Intracranial Aneurysms

Neurosurgery ◽  
2015 ◽  
Vol 77 (3) ◽  
pp. 433-442 ◽  
Author(s):  
Allen L. Ho ◽  
Ning Lin ◽  
Kai U. Frerichs ◽  
Rose Du
Keyword(s):  
Intracranial Aneurysms ◽  
Cerebral Aneurysms ◽  
Aneurysm Rupture ◽  
Extrinsic Factors ◽  
Flow Angle ◽  
Computed Tomographic ◽  
Ruptured Aneurysms ◽  
Unruptured Intracranial Aneurysms ◽  
Risk Of Rupture ◽  
History Of

Abstract BACKGROUND: As diagnosis and treatment of unruptured intracranial aneurysms continues to increase, management principles remain largely based on size. This is despite mounting evidence that aneurysm location and other morphologic variables could play a role in predicting overall risk of rupture. Morphological parameters can be divided into 3 main groups, those that are intrinsic to the aneurysm, those that are extrinsic to the aneurysm, and those that involve both the aneurysm and surrounding vasculature (transitional). OBJECTIVE: We present an evaluation of intrinsic, transitional, and extrinsic factors and their association with ruptured aneurysms. METHODS: Using preoperative computed tomographic angiography, we generated 3-dimensional models of aneurysms and their surrounding vasculature with Slicer software. Using univariate and multivariate analyses, we examined the association of intrinsic, transitional, and extrinsic aspects of aneurysm morphology with rupture. RESULTS: Between 2005 and 2013, 227 cerebral aneurysms in 4 locations were evaluated/treated at a single institution, and computed tomographic angiographies of 218 patients (97 unruptured and 130 ruptured) were analyzed. Ruptured aneurysms analyzed were associated with clinical factors of absence of multiple aneurysms and history of no prior rupture, and morphologic factors of greater aspect ratio. On multivariate analysis, aneurysm rupture remained associated with history of no prior rupture, greater flow angle, greater daughter-daughter vessel angle, and smaller parent-daughter vessel angle. CONCLUSION: By studying the morphology of aneurysms and their surrounding vasculature, we identified several parameters associated with ruptured aneurysms that include intrinsic, transitional, and extrinsic factors of cerebral aneurysms and their surrounding vasculature.

Sign in / Sign up

Export Citation Format

Share Document