Cerebral aneurysms: Conflicts and future trends.

Document Type : Original Article

Authors

1 Department of Neurosurgery, Faculty of Medicine, Sohag University

2 Department of Neurosurgery, Faculty of Medicine, Assuit University

3 Departmenr of Neurosurgery, Regensburg University, Germany

Abstract

Cerebral aneurysms are pouch-like focal dilatations of intracranial arteries, which usually occurred at their branching points. Most of these aneurysms remain asymptomatic and never ruptures. When an aneurysm ruptures, it may bleed into the brain parenchyma resulting in a parenchymal hemorrhage, or more often, it will bleed into the subarachnoid space, resulting in a subarachnoid hemorrhage (SAH). Cerebral aneurysms are not a disease unique to the modern society and a lot of improvements have been achieved especially in its treatment in the second half of the 20th century, especially after the adoption of microsurgical techniques and FDA approval for detachable coils as Endovascular techniques to treat cerebral aneurysms in 1995.
The aim of the current study is to review basic knowledge about the cerebral aneurysms, with brief telescopic view on areas of conflicts, to know the current state of research regarding the cerebral aneurysms to conclude what the future research trends should be.

A;1-  Ajay Malhotra, MD, MMM *; Xiao Wu, BS *; Howard P. Forman, MD, MBA; Holly K. Grossetta Nardini, MLS; Charles C. Matouk, MD; Dheeraj Gandhi, MD; Christopher Moore, MD; Pina Sanelli, MD, MPH Ann Intern Med; Growth and Rupture Risk of Small Unruptured Intracranial Aneurysms: A Systematic Review; 2017;167(1):26-33.DOI: 10.7326/M17-0246Published at www.annals.org on 6 June 2017©2017 American college of physicians.
B;2- Bossuyt PM, Raaymakers TW, Bonsel GJ, Rinkel GJ (2005) Screening families for intracranial aneurysms: anxiety, perceived risk, and informed choice. Prev Med 41(3/4):795–799.
3-   Broderick, J.P., C.M. Viscoli, T. Brott, W.N. Kernan, L.M. Brass, E. Feldmann, L.B. Morgenstern, J.L. Wilterdink, R.I. Horwitz, and I. Hemorrhagic Stroke Project, Major risk factorsfor aneurysmal subarachnoid hemorrhage in the young are modifiable. Stroke,2003 34(6): p. 1375-81.
C   ;4- Charles Vega,M.D, Jeremiah V Kwoon, M.D and Sean D. Lavine, M.D. University of California, Irvine, College of Medicine, Irvine, California; Intracranial Aneurysms: Current Evidence and Clinical Practice;  Am Fam Physician. 2002 Aug 15;66(4):601-609.
5- Conway JE, Hutchins GM, Tamargo RJ (2001) Lack of evidence for an association between neurofi bromatosis typeI and intracranial aneurysms: autopsy study and review of the literature. Stroke 32:2481–2485.
D ;6- Dankbaar, J.W., A.J. Slooter, G.J. Rinkel, and I.C. Schaaf, Effect of different componentsof triple-H therapy on cerebral perfusion inpatients with aneurysmal subarachnoid haemorrhage:a systematic review. Crit Care, 2010. 14(1): p. R23.
7-  Diringer MN, Bleck TP. Claude Hemphill J 3rd, et al. Critical care management of patients following aneurysmal subarachnoid hemorrhage: recommendations from the Neurocritical Care Society's Multidisciplinary Consensus Conference. Neurocrit Care. 2011 Sep;15(2):211–240.
E  ;8- Eddleman, C.S., M.C. Hurley, A.M. Naidech, H.H. Batjer, and B.R. Bendok, Endovascularoptions in the treatment of delayed ischemic neurological deficits due to cerebral vasospasm. Neurosurg Focus, 2009. 26(3): p.E6.
F ;9- Fogelholm, R., J. Hernesniemi, and M. Vapalahti, Impact of early surgery on outcome after aneurysmal subarachnoid hemorrhage. A population-based study.Stroke, 1993. 24(11): p.1649-54.
10- Frosen, J., A. Piippo, A. Paetau, M. Kangasniemi, M. Niemela, J. Hernesniemi, and J. Jaaskelainen, Remodeling of saccular cerebralartery aneurysm wall is associated with rupture: histological analysis of 24 unruptured and 42ruptured cases. Stroke, 2004. 35(10): p. 2287-93.
G;11- Gaal, E.I., On the genetics of intracranial aneurysms and on growth factor induced angiogenesis in the murine brain, in Neurosurgery.2012, Helsinki university Helsinki.
12- Griewing B, Motsch L, Piek J, Schminke U, Brassel F, Kessler C (1998) Transcranial power mode Doppler duplex sonography of intracranial aneurysms. J Neuroimaging 8:155–158
H;13-   Harrod, C.G., H.H. Batjer, and B.R. Bendok, Deficiencies in estrogen-mediated regulation of cerebrovascular homeostasis may contribute to an increased risk of cerebral aneurysm pathogenesis and rupture in menopausal and postmenopausal women. Med Hypotheses,2006. 66(4): p. 736-56.
14- Hoh BL, Topcuoglu MA, Singhal AB, Pryor JC, Rabinov JD, Rordorf GA, Carter BS, Ogilvy CS (2004) Effect of clipping, craniotomy, or intravascular coiling on cerebral vasospasm and patient outcome after aneurysmal subarachnoid hemorrhage. Neurosurgery 55(4):779–786; discussion 786–789
J;15- J.B. Bederson, I.A. Awad, D.O. Wiebers, D. Piepgras, E.C. Haley Jr., T. Brott, et al. Recommendations for the management of patients with unruptured intracranial aneurysms: a statement for health care professionals from the Stroke Council of the American Heart AssociationCirculation, 102 (2000), p. 2300
16- Juvela S., Poussa K., Porras M. (2001). Factors affecting formation and growth of intracranial aneurysms: a long-term follow-up study. Stroke 32, 485–49110.1161/01.STR.32.8.1933 
K;17- Korja, M., K. Silventoinen, P. McCarron, S. Zdravkovic, A. Skytthe, A. Haapanen, U.de Faire, N.L. Pedersen, K. Christensen, M. Koskenvuo, J. Kaprio, and E.P. Genom, Geneticepidemiology of spontaneous subarachnoidhemorrhage: Nordic Twin Study. Stroke, 2010. 41(11): p. 2458-62.
L;18- Laaksamo, E., R. Tulamo, M. Baumann, R. Dashti, J. Hernesniemi, S. Juvela, M. Niemela, and A.Laakso, Involvement of mitogen-activated protein kinase signaling ingrowth and rupture of human intracranial aneurysms.Stroke, 2008. 39(3): p. 886-92.
19- Laslo AM, Eastwood JD, Chen FX, Lee TY (2006) Dynamic CT perfusion imaging in subarachnoid hemorrhagerelated vasospasm. AJNR Am J Neuroradiol 27(3):624–631
M;20- Meng H., Wang Z., Hoi Y., Gao L., Metaxa E., Swartz D. D., Kolega J. (2007). Complex hemodynamics at the apex of an arterial bifurcation induces vascular remodeling resembling cerebral aneurysm initiation. Stroke 38, 1924–193110.1161/STROKEAHA.106.481234 
21- Molyneux A, Kerr R, Stratton I, et al. International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group. International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet. 2002;360:1267–74.
22- Morita, A., S. Fujiwara, K. Hashi, H. Ohtsu, and T. Kirino, Risk of rupture associated with intact cerebral aneurysms in the Japanesepopulation: a systematic review of the literature from Japan. J Neurosurg, 2005. 102(4): p. 601- 6.
Q;23- Qureshi AI, Janardhan V, Hanel RA, Lanzino G (2007) Comparison of endovascular and surgical treatments for intracranial aneurysms: an evidence-based review. Lancet Neurol 6(9):816–825
R;24- R.J. Komotar, J. Mocco, R.A. Solomon Guidelines for the surgical treatment of unruptured intracranial aneurysms: the first annual J. Lawrence pool memorial research symposium-controversies in the management of cerebral aneurysms Neurosurgery, 62 (2008), pp. 183–193
25- Rowe A. J., Finlay H. M., Canham P. B. (2003). Collagen  biomechanics in cerebral arteries and bifurcations assessed by polarizing microscopy. J. Vasc. Res. 40, 406–41510.1159/000072831[PubMed]
26- Ryu C. W., Kwon O. K., Koh J. S., Kim E. J. (2010). Analysis of aneurysm rupture in relation to the geometric indices: aspect ratio, volume, and volume-to-neck ratio. Neuroradiology.[Epub ahead of print]. [PubMed]
S;27- Shojima M., Oshima M., Takagi K., Torii R., Hayakawa M., Katada K., Morita A., Kirino T. (2004).Magnitude and role of wall shear stress on cerebral aneurysm: computational fluid dynamic study of 20 middle cerebral artery aneurysms. Stroke 35, 2500–250510.1161/01.STR.0000144648.89172.
28-  Stapf C, Mohr JP, Pile-Spellman J, Sciacca RR, Hartmann A, Schumacher HC, Mast H (2002) Concurrent arterial aneurysms in brain arteriovenous malformations with haemorrhagic presentation. J Neurol Neurosurg Psychiatr 73:294–298
29- Swietaszczyk C., Maciaczyk J., Tafil-Klawe M., Kasprzak H. A. (2004). what is the origin of cerebral aneurysms? Prz.Lek. 61, 115–119 [PubMed]
T;30- Torner JC, Kassell NF, Wallace RB, Adams HP Jr (1981) Preoperative prognostic factors for rebleeding and survival in aneurysm patients receiving antifibrinolytic therapy: report of the Cooperative Aneurysm Study. Neurosurgery 9:506–513
31-Tulamo, R., J. Frosen, S. Junnikkala, A. Paetau, J. Pitkaniemi, M. Kangasniemi, M. Niemela, J. Jaaskelainen, E. Jokitalo, A. Karatas, J. Hernesniemi, and S. Meri, Complement activation associates with saccular cerebral arteryaneurysm wall degeneration and rupture.Neurosurgery, 2006. 59(5): p. 1069-76; discussion1076-7.
V;32- Van der Drift, J. H. A.: Electroencephalography and cerebral tumors. In Magnus, O., et al.: Suppl. No. 19, EEG-Journal, Elsevier, Amsterdam 1961 (pp. 156-159)
W;33- Wermer MJ, van der Schaaf IC, Algra A, Rinkel GJ (2007) Risk of rupture of unruptured intracranial aneurysms in relation to patient and aneurysm characteristics: an updated meta-analysis. Stroke 38(4):1404–1410. Epub 2007 Mar 1
34- White PM, Wardlaw JM, Teasdale E, Sloss S, Cannon J, Easton V (2001) Power transcranial Doppler ultrasound in the detection of intracranial aneurysms. Stroke 32:1291–1297
35-Wiebers D, Whisnant JP, Huston J III, Meissner I, Brown RD Jr, Piepgras DG, Forbes GS, Thielen K, Nichols D, O’Fallon WM, Peacock J, Jaeger L, Kassell NF, Kongable- Beckman GL, Torner JC (2003) Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet 2003, 362: p103–110 imaging. J Neurosurg 96:684–689
Y36-Yaşargil, M.G., Microneurosurgery. Vol I.: Georg Thieme Verlag.In Thompson, R. A., J. R. Green Advances in Neurology. Raven, 1984: Stuttgart (pp. 181-209). 
37- Yasuno, K., K. Bilguvar, P. Bijlenga, S.K. Low, B. Krischek, G. Auburger, M. J. Hernesniemi, G.J. Rinkel, H. Zembutsu, I. Inoue, A. Palotie, F. Cambien, Y. Nakamura, R.P. Lifton, and M. Gunel, Genome-wide associationstudy of intracranial aneurysm  identifies three new risk loci. Nat Genet, 2010. 42(5): p. 420-5.
38- Zal. Ghassan Kerry, Alexander Hammer , Anahi Steiner, Gholamreza Ranaie, Ingrid Baer, Christian, Stefan Kunze, Hans-Herbert Steiner Published: Treatment of ruptured intracranial aneurysms yesterday and now, neurosurgery journal,central Europ ,germany, https://doi.org/10.1371/journal.pone.0172837 March 3, 2017.
39- zanne M. Dorhout Mees, MD; Andrew J. Molyneux, MD, PhD; Richard S. Kerr, MD, PhD; Ale Algra, MD, PhD; Gabriel J.E. Rinkel, MD, PhD, University of Oxford and Oxford Radcliffe Hospitals, National Health Service Trust, Radcliffe Infirmary, Oxford, United Kingdom.; Timing of Aneurysm Treatment After Subarachnoid Hemorrhage Relationship With Delayed Cerebral Ischemia and Poor Outcome, Stroke J. 2012;43:2126-2129.April 4, 2012.