Relationship between Estrogen Hormone and Rupture of Cerebral Aneurysm in Premenopausal Women

Abstract

The incidence of subarachnoid hemorrhage (SAH) in women increase after menopause. Estrogen hormone had been implicated in cerebral aneurysm formation, growth and rupture. The aim of this study was to examine the association between estrogen hormone and presence of aneurysmal SAH in premenopausal women. Methods: Between February 2015 and December 2016, 40 patients at consecutive premenopausal women (mean age, 41 years) with aneurysms SAH, were treated in our hospital. The data of patients with clinical and gynecological history were analyzed and compared with control group with age matched, case-control study. Results: Single and multivariate analysis showed that estrogen hormone (estradiol) had a lower trend towards at premenopause age comparing with control group, statistically was significant (p<0.001). No significant association of SAH was found with gynecological and clinical factors (p>0.05). Conclusion: In our study, there is a trend showing that an earlier age at menopause relating to estrogen hormone deficiency is associated with the aneurysmal SAH. These data may help to identify a risk factor for pathogenesis of cerebral aneurysm and also a potential target for future therapies.

Is sex a predictor for delayed cerebral ischaemia (DCI) and hydrocephalus after aneurysmal subarachnoid haemorrhage (aSAH)? A systematic review and meta-analysis

“…It is known to increase nitric oxide (NO) bioavailability, and also regulates the prostacyclin and thromboxane A2 that maintain the vascular tone in females [22]. Oestrogen deficiency, which may contribute to aSAH in the first place [15], could lead to loss of vasodilatory effects and resultant ischaemia in women. In support of this hypothesis, there are animal studies that suggest that steroids including estradiol could be useful to relieve cerebral vasospasm [3,18].…”