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[Congenital anomalies of cerebral artery and intracranial aneurysm]
Insights
Cerebrovascular anomalies, including persistent trigeminal artery and fenestration, significantly increase the risk of developing intracranial aneurysms. These findings suggest a genetic link in cerebral vessel defects contributing to aneurysm formation.
Area of Science:
- Neurology
- Vascular Medicine
- Genetics
Background:
- Congenital anomalies like polycystic kidney disease and Marfan syndrome are known risk factors for intracranial aneurysms.
- The precise relationship and incidence between cerebrovascular anomalies and intracranial aneurysms require further elucidation.
Purpose of the Study:
- To investigate the incidence and relationship between specific cerebrovascular anomalies and intracranial aneurysms.
- To explore the etiological factors contributing to the development of intracranial aneurysms.
Main Methods:
- Retrospective analysis of 3841 patients undergoing angiography over five years.
- Identification and categorization of cerebrovascular anomalies: persistent trigeminal artery, persistent hypoglossal artery, and fenestration.
- Comparison of aneurysm incidence in patients with cerebrovascular anomalies versus those with intracerebral hematomas.
Main Results:
- Incidence rates: persistent trigeminal artery (0.31%), persistent hypoglossal artery (0.05%), fenestration (0.29%).
- Aneurysms/AVMs occurred in 30.8% of patients with cerebrovascular anomalies (8 out of 26 cases).
- Intracranial aneurysms were found in 10.7% of patients with thalamic or caudate hemorrhage, a significantly lower incidence than in cerebrovascular anomalies (P < 0.05).
Conclusions:
- Cerebrovascular anomalies are significantly associated with a higher incidence of intracranial aneurysms.
- Genetic errors in cerebral vessel development, particularly defects in the tunica media, are implicated as a primary cause of intracranial aneurysms.
Abstract:
It is well known that congenital anomalies such as polycystic kidney, aortic coarctation, Marfan syndrome, Ehler-Danlos syndrome are apt to be complicated by intracranial aneurysms. In this report we attempt to reveal the relation and incidence between cerebrovascular anomalies and intracranial aneurysms. The etiology of aneurysms has been discussed, too. 12 cases of persistent trigeminl artery, 2 cases of persistent hypoglossal artery and 11 cases of fenestration were obtained from 3841 patients who were angiographically examined in our clinic for 5 years. The incidence is 0.31%, 0.05% and 0.29%, respectively. Persistent trigeminal arteries were complicated by 2 cases of intracranial aneurysms and one case of arterivenous malformations (AVM), persistent hypoglossal arteries were complicated by one case of aneurysm, and fenestrations were complicated by 2 cases of aneurysms and one case of AVM. One case of congenital agenesis of right internal carotid artery was obtained which was complicated by aneurysm of anterior communicating artery. Totally, 8 cases of aneurysms and AVM were obtained from 26 cases of cerebrovascular anomalies (incidence 30.8%). On the other hand, thalamic or caudate hemorrhage revealed the highest incidence of complication of intracranial aneurysms among intracerebral hematomas (10.7%). Compared with the incidence of aneurysms between cerebro vascular anomalies (30.8%) and thalamic or caudate hemorrhage (10.7%), the difference is statistically signigicant (P less than 0.05). The cause of intracranial aneurysm has not yet been clarified. But it is well accepted that the defect of tunica media vasorum is most responsible factor as to the occurrence of intracranial aneurysms. We concluded that the genetic error of cerebral vessels including defect of media caused intracranial aneurysms, and this result was supported from the evidence that cerebrovascular anomalies showed statistically high incidence of complication of intracranial aneurysms.