Characteristics of patients with cerebral aneurysms and arteriovenous malformations
DOI:
https://doi.org/10.15584/ejcem.2024.2.7Keywords:
aneurysm, arteriovenous malformation, digital subtraction angiographyAbstract
Introduction and aim. Aneurysms and arteriovenous malformations (AVMs) are both vascular abnormalities that can occur simultaneously or separately and increase the risk of intracerebral hemorrhage. The aim of this research was to characterize patients with intracranial aneurysms and AVMs.
Material and methods. This retrospective research was based on analysis of Digital Subtraction Angiography. The research group consisted of 118 patients. StatSoft STATISTICA 13 was used for the statistical analysis of parameters, such as dimensions and vascularization pattern of vascular abnormalities.
Results. The total number of aneurysms described was 168. In addition, 33 patients with cerebral aneurysms were also diagnosed with cerebral AVMs. The average dimensions of the aneurysms were 6.33mm, 95% CI (5.47 7.18) × 4.76mm, 95% CI (4.09, 5.43). The abnormalities were found in the extent of circulation of ACA (anterior cerebral artery) 50 (29.76%), ICA (internal carotid artery) 48 (28.57%), MCA (middle cerebral artery) 26 (15.48%), PCA (posterior cerebral artery) 23 (13.69%). There were 76 (64%) patients with diagnosed single aneurysms and 42 (36%) with multiple.
Conclusion. Aneurysms are more likely to occur singly than multiply. The majority are located within the vascularization of the ACA. Aneurysms can coexist with AVMs, which increases the risk of rupture.
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References
Krings T, Mandell DM, Kiehl TR, et al. Intracranial aneurysms: from vessel wall pathology to therapeutic approach. Nat Rev Neurol. 2011;7(10):547-559. doi: 10.1038/nrneurol.2011.136
Xu Z, Rui YN, Hagan JP, Kim DH. Intracranial aneurysms: Pathology, genetics, and molecular mechanisms. Neuromolecular Med. 2019;21(4):325-343. doi: 10.1007/s12017-019-08537-7
Turan N, Heider RAJ, Zaharieva D, Ahmad FU, Barrow DL, Pradilla G. Sex differences in the formation of intracranial aneurysms and incidence and outcome of subarachnoid hemorrhage: Review of experimental and human studies. Transl Stroke Res. 2016;7(1):12-19. doi: 10.1007/s12975-015-0434-6
Jersey AM, Foster DM. Cerebral Aneurysm. StatPearls Publishing; 2023.
Ellamushi HE, Grieve JP, Jäger HR, Kitchen ND. Risk factors for the formation of multiple intracranial aneurysms. J Neurosurg. 2001;94(5):728-732. doi: 10.3171/jns.2001.94.5.0728
Wilkinson DA, Heung M, Deol A, et al. Cerebral aneurysms in Autosomal dominant polycystic kidney disease: A comparison of management approaches. Neurosurgery. 2019;84(6):352-361. doi: 10.1093/neuros/nyy336
Jung KH. New pathophysiological considerations on cerebral aneurysms. Neurointervention. 2018;13(2):73-83. doi: 10.5469/neuroint.2018.01011
Olubajo F, Kaliaperumal C, Choudhari KA. Vascular Ehlers-Danlos Syndrome: Literature review and surgical management of intracranial vascular complications. Clin Neurol Neurosurg. 2020;193(105775):105775. doi: 10.1016/j.clineuro.2020.105775
Schievink WI, Parisi JE, Piepgras DG, Michels VV. Intracranial aneurysms in marfan’s syndrome: An autopsy study. Neurosurgery. 1997;41(4):866-871. doi: 10.1097/00006123-199710000-00019
Pritz MB. Cerebral aneurysm classification based on angioarchitecture. J Stroke Cerebrovasc Dis. 2011;20(2):162-167. doi: 10.1016/j.jstrokecerebrovasdis.2009.11.018
Ozpinar A, Mendez G, Abla AA. Epidemiology, genetics, pathophysiology, and prognostic classifications of cerebral arteriovenous malformations. In: Handbook of Clinical Neurology. Elsevier; 2017:5-13.
Wilkins RH. Natural history of intracranial vascular malformations: A review. Neurosurgery. 1985;16(3):421-430. doi: 10.1227/00006123-198503000-00026
Findlay JM, Deagle GM. Causes of morbidity and mortality following intracranial aneurysm rupture. Can J Neurol Sci. 1998;25(3):209-215. doi: 10.1017/s031716710003403x
Platz J, Berkefeld J, Singer OC, et al. Frequency, risk of hemorrhage and treatment considerations for cerebral arteriovenous malformations with associated aneurysms. Acta Neurochir (Wien). 2014;156(11):2025-2034. doi: 10.1007/s00701-014-2225-3
Cianfoni A, Pravatà E, De Blasi R, Tschuor CS, Bonaldi G. Clinical presentation of cerebral aneurysms. Eur J Radiol. 2013;82(10):1618-1622. doi: 10.1016/j.ejrad.2012.11.019
Pereira VM, Bijlenga P, Marcos A, Schaller K, Lovblad KO. Diagnostic approach to cerebral aneurysms. Eur J Radiol. 2013;82(10):1623-1632. doi: 10.1016/j.ejrad.2012.10.014
Sebök M, Dufour JP, Cenzato M, et al. When Is Diagnostic Subtraction Angiography Indicated Before Clipping of Unruptured and Ruptured Intracranial Aneurysms? An International Survey of Current Practice. Acta Neurochir Suppl. 2021;132:9-17.
Hussain S, Barbarite E, Chaudhry NS, et al. Search for biomarkers of intracranial aneurysms: A systematic review. World Neurosurg. 2015;84(5):1473-1483. doi: 10.1016/j.wneu.2015.06.034
Kamińska J, Dymicka-Piekarska V, Chrzanowski R, et al. IL-6 quotient (the ratio of cerebrospinal fluid IL-6 to serum IL-6) as a biomarker of an unruptured intracranial aneurysm. J Inflamm Res. 2021;14:6103-6114. doi: 10.2147/jir.s335618
Sharma T, Datta KK, Kumar M, et al. Intracranial aneurysm biomarker candidates identified by a proteome-wide study. OMICS. 2020;24(8):483-492. doi: 10.1089/omi.2020.0057
Tanzadehpanah H, Modaghegh MHS, Mahaki H. Key biomarkers in cerebral arteriovenous malformations: Updated review. J Gene Med. 2023;25(12):3559. doi: 10.1002/jgm.3559
Din M, Agarwal S, Grzeda M, Wood DA, Modat M, Booth TC. Detection of cerebral aneurysms using artificial intelligence: a systematic review and meta-analysis. J Neurointerv Surg. 2023;15(3):262-271. doi: 10.1136/jnis-2022-019456
Zhao J, Lin H, Summers R, Yang M, Cousins BG, Tsui J. Current treatment strategies for intracranial aneurysms: An overview. Angiology. 2018;69(1):17-30. doi: 10.1177/0003319717700503
Shimizu K, Imamura H, Tani S, et al. Candidate drugs for preventive treatment of unruptured intracranial aneurysms: A cross-sectional study. PLoS One. 2021;16(2):0246865. doi: 10.1371/journal.pone.0246865
Tanzadehpanah H, Lotfian E, Avan A, et al. Role of SARS-COV-2 and ACE2 in the pathophysiology of peripheral vascular diseases. Biomed Pharmacother. 2023;166(115321):115321. doi: 10.1016/j.biopha.2023.115321
Rammos SK, Gardenghi B, Bortolotti C, Cloft HJ, Lanzino G. Aneurysms associated with brain arteriovenous malformations. AJNR Am J Neuroradiol. 2016;37(11):1966-1971. doi: 10.3174/ajnr.a4869
Brown RD, Wiebers DO, Forbes GS. Unruptured intracranial aneurysms and arteriovenous malformations: frequency of intracranial hemorrhage and relationship of lesions. J Neurosurg. 1990;73(6):859-863. doi: 10.3171/jns.1990.73.6.0859
Wiebers DO. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet. 2003;362(9378):103-110. doi: 10.1016/s0140-6736(03)13860-3
Shen X, Xu T, Ding X, Wang W, Liu Z, Qin H. Multiple intracranial aneurysms: Endovascular treatment and complications. Interv Neuroradiol. 2014;20(4):442-447. doi: 10.15274/inr-2014-10037
Gao BL, Hao H, Hao W, Ren CF, Yang L, Han Y. Cerebral aneurysms at major arterial bifurcations are associated with the arterial branch forming a smaller angle with the parent artery. Sci Rep. 2022;12(1):5106. doi: 10.1038/s41598-022-09000-7
Kaminogo M, Yonekura M, Shibata S. Incidence and outcome of multiple intracranial aneurysms in a defined population. Stroke. 2003;34(1):16-21. doi: 10.1161/01.str.0000046763.48330.ad
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