A Review of Genetic Polymorphisms and Susceptibilities to Complications after Aneurysmal Subarachnoid Hemorrhage

Abstract

Delayed cerebral ischemia (DCI) and vasospasm are two complications of subarachnoid hemorrhages (SAHs) which entail high risks of morbidity and mortality. However, it is unknown why only some patients who suffer SAHs will experience DCI and vasospasm. The purpose of this review is to describe the main genetic single nucleotide polymorphisms (SNPs) that have demonstrated a relationship with these complications. The SNP of the nitric oxide endothelial synthase (eNOS) has been related to the size and rupture of an aneurysm, as well as to DCI, vasospasm, and poor neurological outcome. The SNPs responsible for the asymmetric dimetilarginine and the high-mobility group box 1 have also been associated with DCI. An association between vasospasm and the SNPs of the eNOS, the haptoglobin, and the endothelin–1 receptor has been found. The SNPs of the angiotensin-converting enzyme have been related to DCI and poor neurological outcome. Studies on the SNPs of the Ryanodine Receptor yielded varying results regarding their association with vasospasm.

Severe Cerebral Vasospasm Caused by Acute on Top of Chronic Spontaneous Subdural Hematoma: A Case Report and Review of the Literature

“…Cerebral vasospasm following SAH is very well studied and generally occurs in 30% of patients with about 20% having a significant morbidity and/or mortality. Pathophysiology is poorly understood and probably involves irritation of the blood vessels by toxic products released into the arachnoid space [ 1 , 5 , 6 ]. Some genetic factors are recently implicated in the severity of clinical vasospasm [ 6 , 7 ].…”

“…Pathophysiology is poorly understood and probably involves irritation of the blood vessels by toxic products released into the arachnoid space [ 1 , 5 , 6 ]. Some genetic factors are recently implicated in the severity of clinical vasospasm [ 6 , 7 ]. Vasospasm usually occurs between three and 14 days after SAH with risk factors such as the severity of SAH, degree of motor deficit, as well as endovascular therapy being the most significant [ 5 , 8 , 9 ].…”

Immunological Profile of Vasospasm after Subarachnoid Hemorrhage

“…As the occurrence of EBI, DCI and vasospasm is variable across patients with SAH, research has progressively investigated mutations and polymorphisms at sites other than END1, aiming to find a clue to the higher susceptibility to SAH complications [113,114]. An association between vasospasm and the SNPs of nitric oxide endothelial synthase (eNOS), haptoglobin and END1 receptor has been found in different studies [114,115].…”

The Role of Epigenetics in Brain Aneurysm and Subarachnoid Hemorrhage: A Comprehensive Review

“…Recent years have witnessed an increased interest in studies exploring the genetic and epigenetic interactions underlying the pathogenesis of IA and aSAH. While the genetic advances have been summarized elsewhere [ 10 ], this comprehensive review seeks to elucidate the current state of knowledge regarding the role of epigenetics in the development of IA and aSAH, including the emergence of complications such as VS and DCI as well as the prognosis.…”