Aneurysm Size is the Strongest Risk Factor for Intracranial Aneurysm Growth in the Eastern Finnish Population

Björkman, Joel; Frösén, Juhana; Tähtinen, Olli; Huttunen, Terhi; Huttunen, Jukka; Kurki, Mitja; Fraunberg, Mikael von und zu; Koivisto, Timo; Manninen, Hannu; Jääskeläinen, Juha E.; Lindgren, Antti

doi:10.1093/neuros/nyy161

Cited by 19 publications

(21 citation statements)

References 21 publications

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“…Furthermore, a high percentage of patients included in this study is Finnish and the period of inclusion is heterogeneous which may limit the generalizability of the results. A higher incidence of aSAH and different patient and aneurysm characteristics have been reported for Finnish patients [28, 29,30], however in our subgroup analysis excluding Finnish (and Inuit) populations results remained essentially the same. Therefore, we do not believe that inclusion of these patients has influenced our findings to large extent.…”

Section: Discussionsupporting

confidence: 46%

Patient and aneurysm characteristics in familial intracranial aneurysms. A systematic review and meta-analysis

et al. 2019

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Background and purpose Patient and aneurysm characteristics have been reported to differ between patients with familial and non-familial intracranial aneurysms (IAs), although results are inconsistent. We systematically reviewed and meta-analyzed the literature to identify and quantify patient- and aneurysm characteristics associated with familial IAs. Methods We searched PubMed and EMBASE for case-control and cohort studies comparing patient- and aneurysm characteristics between familial and non-familial IAs. Two observers independently assessed study eligibility and appraised quality with the Newcastle Ottawa Scale. With univariable weighted linear regression analysis we calculated β-coefficients with corresponding 95% confidence intervals (CIs) for ruptured and unruptured IAs combined and for ruptured IAs only. Heterogeneity was assessed with Higgins I 2 . Results A total of 15 articles were included in the meta-analysis in which 16,346 patients were analyzed with a total of 14,225 IAs. For ruptured and unruptured IAs combined, multiple IAs were more prevalent in familial (28.5%) than in non-familial IAs (20.4%; β = 0.10, 95% CI, 0.04 to 0.16; I 2 0%). For ruptured IAs only, in familial patients IAs were more prevalent on the middle cerebral artery (41.1% versus 29.5%; β = 0.12, 95% CI, 0.01 to 0.24; I 2 12%) and ruptured at a younger age (46.5 years versus 50.8 years; β = -5.00, 95% CI, -9.31 to -0.69; I 2 98%) than in non-familial patients. No significant differences were found for the proportion of women, size of the aneurysm at time of rupture, smoking or hypertension. Conclusion These results suggest that characteristics of familial and non-familial IAs show considerable overlap, yet differ on specific aspects. However, results for age at rupture showed considerable heterogeneity. These findings should be taken into consideration for future etiological research into IAs.

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Section: Discussionsupporting

confidence: 46%

Patient and aneurysm characteristics in familial intracranial aneurysms. A systematic review and meta-analysis

et al. 2019

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“…1 They are usually located in the anterior circulation. 5 The patient described in this report had seven aneurysms in the anterior circulation. The management of MIAs is somewhat challenging in two key aspects: identification of the ruptured aneurysm and choosing the most appropriate treatment modality (coiling and/or clipping).…”

Section: Discussionmentioning

confidence: 78%

“…With respect to the identification of the ruptured aneurysm in the case of MIAs, these criteria could be adopted: (1) the site of maximum SAH concentration on CT images, (2) larger aneurysm size, (3) larger aspect ratio (dome height to neck width), and (4) aneurysm with an irregular shape. [5][6][7] These characteristics are significantly correlated with aneurysm rupture. In recent years, the application of high-resolution magnetic resonance imaging (MRI) has provided more reliable evidence for predicting the probability of aneurysm rupture.…”

Section: Discussionmentioning

confidence: 99%

Single-Stage Clipping of Seven Intracranial Aneurysms in the Anterior Circulation via Unilateral Pterional Approach: A Case Report and Literature Review

Hou

et al. 2020

J Neurol Surg A Cent Eur Neurosurg

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The occurrence of multiple intracranial aneurysms (MIAs) is not rare, with a reported incidence of 15 to 35%. However, patients harboring seven or more intracranial aneurysms are so uncommon that only sporadic cases have ever been reported. We present a rare case with seven intracranial aneurysms (two anterior communicating artery aneurysms, two right middle cerebral artery aneurysms, two left ophthalmic artery aneurysms, and one right ophthalmic artery aneurysm) in the anterior circulation that were simultaneously clipped via the extended right pterional approach. The surgery was uneventful. The patient experienced a rapid postoperative recovery with no neurologic deficits. To our knowledge, this is the first case of seven bilateral intracranial aneurysms that were surgically clipped via unilateral craniotomy. This case showed that in properly selected patients with anterior circulation MIAs, even as many as seven, one-stage clipping can be achieved. Successful clipping of the contralateral ophthalmic aneurysms was the key step in the operation.

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“… 13 Hypertension is a major risk factor for IA. 2 , 8 , 9 Therefore, miR-130a might also participate in IA. This study first reported upregulation of mature miR-130a and decreased premature miR-130a expression in IA.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have elucidated the correlation between IA development and many risk factors, such as alcoholism, tobacco consumption, hypertension, obesity, head trauma, and infections. 2 , 8 , 9 Besides, alterations in the expression of some molecular factors may also contribute to IA. 10 For instance, lncRNAs and miRNAs affect protein production and regulate other noncoding RNAs to regulate IA growth and rupture.…”

Section: Introductionmentioning

confidence: 99%

LncRNA SAMMSON Overexpression Suppresses Vascular Smooth Muscle Cell Proliferation via Inhibiting miR-130a Maturation to Participate in Intracranial Aneurysm

Pan

Gao

Wan

et al. 2021

NDT

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Background MiR-130a is a recently identified critical player in vascular smooth muscle cell (VSMC) proliferation, which participates in intracranial aneurysm (IA). However, the involvement of miR-130a in IA and its upstream regulator are unknown. Our preliminary sequencing analysis revealed a close correlation between miR-130a and lncRNA SAMMSON across IA samples. Therefore, we further studied the crosstalk between SAMMSON and miR-130a in IA. Methods SAMMSON and miR-130a expression were measured using RT-qPCR. SAMMSON subcellular location was analyzed with nuclear fractionation assay. Their direct interaction was explored with RNA pull-down assay. The role of SAMMSON in miR-130a maturation was studied with overexpression analysis. VSMC cell proliferation was analyzed with BrdU assay. Results SAMMSON and premature miR-130a were deregulated in IA, while mature miR-130a was upregulated in IA. SAMMSON is localized in both the nucleus and cytoplasm, and direct interaction between SAMMSON and miR-130a was observed. SAMMSON overexpression suppressed miR-130a maturation in VSMCs and reduced the enhancing effects of miR-130a on VSMC cell proliferation. Conclusion SAMMSON is overexpressed in IA and suppresses VSMC proliferation via inhibiting miR-130a maturation.

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Aneurysm Size is the Strongest Risk Factor for Intracranial Aneurysm Growth in the Eastern Finnish Population

Abstract: Our study indicates that aneurysm size is the strongest risk factor for aneurysm growth in Eastern Finnish population. Further studies are required to identify new risk factors for aneurysm growth.

Cited by 19 publications

References 21 publications

Patient and aneurysm characteristics in familial intracranial aneurysms. A systematic review and meta-analysis

Patient and aneurysm characteristics in familial intracranial aneurysms. A systematic review and meta-analysis

Single-Stage Clipping of Seven Intracranial Aneurysms in the Anterior Circulation via Unilateral Pterional Approach: A Case Report and Literature Review

LncRNA SAMMSON Overexpression Suppresses Vascular Smooth Muscle Cell Proliferation via Inhibiting miR-130a Maturation to Participate in Intracranial Aneurysm

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