Are cerebral aneurysms atherosclerotic?

Abstract

Background and Purpose The aim of our study was to investigate plasma and genetic risk factors for rupture of cerebral aneurysms.Methods In London, a case-control study was made of 56 consecutive patients admitted to a regional neurosurgical service for treatment of ruptured cerebral aneurysm and of 93 control subjects. A further 40 consecutive patients admitted in Arhus with ruptured cerebral aneurysm also were studied.Results The British case-control study showed that smoking was associated with an increased risk of ruptured cerebral aneurysm (odds ratio, 9.1; 95% confidence interval [CI], 3.4 to 23.8; P<.001 for a history of >10 pack years). After age and sex adjustment, factors associated with ruptured cerebral aneurysm included a cholesterol concentration in the highest tertile (^6.3 mmol/L; odds ratio, 10.2; 95% CI, 3.9 to 26.7; P<.001), an apolipoprotein B concentration in the highest tertile (a0.84 g/L; odds ratio, 6.4; 95% CI, 2.5 to 16.3; / > <.001), and concentrations of HDL cholesterol in the lowest tertile (<1.1 mmol/L; odds ratio, 3.6; 95% CI, 1.4 to 8.2; P<.01). History of hypertension was of less importance (odds ratio, 4.0; 95% CI, 1.41 to 11.7; /><.01). Smoking history

Risk factors and outcome in 100 patients with aneurysmal subarachnoid hemorrhage

“…The smaller quantity of connective tissue surrounding cerebral vessels 17 , the attenuated tunica media and lack of external elastic lamina of intracranial arteries may be key ethiological features. Arterial hypertension coexists in high percentage of patients 6,[18][19][20][21][22][23][24][25] and it has been proposed as an etiological factor, even though the exact relationship is not completely defined 26 . Cigarette smoking Posterior cerebral artery 1.00% Table 4.…”

“…General outcome assessed through the Glasgow Outcome Scale (GOS) evaluated upon hospital dischargement and within a three to six-month period of outpatient follow-up. is the single acquired factor that has been proved to confer risk for aneurysmal subarachnoid hemorrhage (3 to 10 times higher among smokers) [18][19][20][21][22][23] . Congenital predisposition for intracranial aneurysm is supported by considerable evidence, particularly concerning inherited connective tissue disorders and familial predisposition.…”

Menstrual and Reproductive Factors for Subarachnoid Hemorrhage Risk in Women

“…3 Several epidemiological studies have examined the risk factors for SAH, primarily focusing on hypertension, 4 -8 smoking habits, 4,7,9,10 and alcohol use. 6,9 -11 In women it was reported that hormone-related factors are in part associated with the occurrence of SAH.…”

Deficiency of total collagen content and of deoxypyridinoline in intracranial aneurysm walls

“…According to some theories, an inherited deficiency of collagen in cerebral arteries may be involved in the development of intracranial aneurysms [3][4][5], while other authors suggest that aneurysms could result from an acquired degeneration of cerebral arteries under the influence of arterial hypertension and atherosclerosis [6].…”

“…Adamson et al [6] showed that the frequencies of polymorphic variations in type III collagen gene loci were not different in affected individuals when compared to control cases, providing no evidence for a genetic predisposition to cerebral aneurysms. Moreover, in some cases of multiple familial aneurysms a type III collagen deficiency was not demonstrated [10], supporting the hypothesis Corresponding author.…”