Role of oral pathogens in the pathogenesis of intracranial aneurysm: review of existing evidence and potential mechanisms

Hallikainen, Joona; Keränen, Sara; Savolainen, Jarno; Närhi, Matti; Suominen, Anna Liisa; Ylöstalo, Pekka; Kellokoski, Jari; Pyysalo, Mikko; Pussinen, Pirkko J.; Rauramaa, Tuomas; Frösén, Juhana

doi:10.1007/s10143-020-01253-y

Cited by 18 publications

(16 citation statements)

References 93 publications

(171 reference statements)

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“…The pathology of IA and abdominal aortic aneurysm shares several features [35] . The current understanding is that IAs formation as the end result of ow-driven in ammatory cell-mediated cerebral artery wall remodeling at sites where high ow exerts high wall shear stress [1] . However, IA is not detected in all cases under high ow and shear stress in the bifurcations of cerebral arteries.…”

Section: Discussionmentioning

confidence: 99%

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Correlation of periodontal diseases with intracranial aneurysm formation: novel predictive indicators

Liu

Sun

Shao

et al. 2021

Preprint

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Background and purpose: We investigated whether periodontal diseases, specifically, periodontitis and gingivitis, could be risk factors of the incidence of intracranial aneurysms (IAs).Methods: We performed a case–control study to compare the differences in the periodontal disease parameters of 281 cases that were divided into the IAs group and non-IAs group. All cases underwent complete radiographic examination for IAs and examination for periodontal health. Results: Comparing with those in the non-IAs group, the cases in the IAs group were older (53.95 ± 8.56 vs 47.79 ± 12.33, p < 0.001) and had a higher incidence of hypertension (76 vs 34, p = 0.006). Univariate logistic regression analysis revealed that age (>50 years) and hypertension were predictive risk factors of aneurysm formation (odds ratio [OR] 1.047, 95% confidence interval [95%CI] 1.022–1.073, p < 0.001 and OR 2.047, 95%CI 1.232–3.401, p = 0.006). In addition, univariate and multivariate logistic regression analyses showed that the parameters of periodontal diseases, including gingival index, plaque index, clinical attachment loss, and alveolar bone loss, were significantly associated with the occurrence of IAs (all p < 0.05). For further statistical investigation, the parameters of periodontal diseases were divided into four layers based on the quartered data. Poorer periodontal health condition (especially gingival index＞1.1 and plaque index＞1.5) had the correlation with IAs formation (p＝0.007 and p＜0.001). Conclusion: Severe gingivitis or periodontitis combining with hypertension, are significantly associated with the incidence of IAs.

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Section: Discussionmentioning

confidence: 99%

“…Intracranial aneurysms (IAs) are pathological dilatations of cerebral arteries; they are most often saccular in shape and frequently found in proximal cerebral artery bifurcations [1] . Subarachnoid hemorrhage caused by IA rupture affects 10-11/100,000 population per year in western populations [2] .…”

Section: Introductionmentioning

confidence: 99%

Correlation of periodontal diseases with intracranial aneurysm formation: novel predictive indicators

Liu

Sun

Shao

et al. 2021

Preprint

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“…The manual rather than automated analysis may have introduced some variability in the results, but it is a much more applicable technique in the www.nature.com/scientificreports/ clinical setting. Furthermore, there may be other factors that may be associated with aneurysm formation, such as a history of chronic inflammatory disease and oral infections, that were not taken into account [31][32][33] . Finally, the superior cerebellar arteries (SCA) which are proximally located to the basilar tip may contribute to the local hemodynamics and affect the results.…”

Section: Discussionmentioning

confidence: 99%

Surrounding vascular geometry associated with basilar tip aneurysm formation

Zhang

Can

Lai

et al. 2020

Sci Rep

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Hemodynamic stress is thought to play an important role in the formation of intracranial aneurysms, which is conditioned by the geometry of the surrounding vasculature. Our goal was to identify image-based morphological parameters that were associated with basilar artery tip aneurysms (BTA) in a location-specific manner. Three-dimensional morphological parameters obtained from CT-angiography (CTA) or digital subtraction angiography (DSA) from 207 patients with BTAs and a control group of 106 patients with aneurysms elsewhere to control for non-morphological factors, who were diagnosed at the Brigham and Women’s Hospital and Massachusetts General Hospital between 1990 and 2016, were evaluated. We examined the presence of hypoplastic, aplastic or fetal PCoAs, vertebral dominance, and diameters and angles of surrounding parent and daughter vessels. Univariable and multivariable statistical analyses were performed to determine statistical significance. Sensitivity analyses with small (≤ 3 mm) aneurysms only and with angles excluded, were also performed. In multivariable analysis, daughter–daughter angle was directly, and parent artery diameter and diameter size ratio were inversely associated with BTAs. These results remained significant in the subgroup analysis of small aneurysms (width ≤ 3 mm) and when angles were excluded. These easily measurable and robust parameters that are unlikely to be affected by aneurysm formation could aid in risk stratification for the formation of BTAs in high-risk patients.

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“…The pathologies of IA and abdominal aortic aneurysm share several features [35] . The current understanding is that IAs form as the end result of ow-driven in ammatory cell-mediated cerebral artery wall remodeling at sites where high ow exerts high wall shear stress [1] . However, IA is not detected in all cases under high ow and shear stress in the bifurcations of cerebral arteries.…”

Section: Discussionmentioning

confidence: 99%

“…Intracranial aneurysms (IAs) are pathological dilatations of cerebral arteries; they are most often saccular in shape and frequently found in proximal cerebral artery bifurcations [1] . Subarachnoid hemorrhages caused by IA rupture are rare events that affect 10-11/100,000 population per year in Western populations [2] .…”

Section: Introductionmentioning

confidence: 99%

Association of Periodontal Diseases with Intracranial Aneurysm Formation: Novel Predictive Indicators

Liu¹,

Sun²,

Shao³

et al. 2020

Preprint

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Abstract Background and purpose: We investigated whether periodontal diseases, specifically, periodontitis and gingivitis, could be risk factors of the incidence of intracranial aneurysms (IAs).Methods: We performed a case–control study to compare the differences in the periodontal disease parameters of 281 cases that were divided into the IA and non-IA groups. All cases underwent complete radiographic examination for IAs and examination for periodontal health. Results: Compared with those in the non-IA group, the cases in the IA group were older (53.95 ± 8.56 vs 47.79 ± 12.33, p < 0.001) and had a higher incidence of hypertension (76 vs 34, p = 0.006). Univariate analysis revealed that age (>50 years) and hypertension were risk factors of aneurysm formation (odds ratio [OR] 1.047, 95% confidence interval [95%CI] 1.022–1.073, p < 0.001 and OR 2.047, 95%CI 1.232–3.401, p = 0.006). In addition, univariate and multivariate logistic regression analyses showed that the parameters of periodontal diseases, including gingival index, plaque index, clinical attachment loss, and alveolar bone loss, were significantly associated with the occurrence of IA (all p < 0.05). For further statistical investigation, the parameters of periodontal diseases were divided into four layers on the basis of their averages. Poor periodontal health condition was correlated with a high risk of IAs. Conclusion: Periodontal diseases, especially severe gingivitis or periodontitis combined with hypertension, were significantly associated with the incidence of IAs.

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Role of oral pathogens in the pathogenesis of intracranial aneurysm: review of existing evidence and potential mechanisms

Cited by 18 publications

References 93 publications

Correlation of periodontal diseases with intracranial aneurysm formation: novel predictive indicators

Correlation of periodontal diseases with intracranial aneurysm formation: novel predictive indicators

Surrounding vascular geometry associated with basilar tip aneurysm formation

Association of Periodontal Diseases with Intracranial Aneurysm Formation: Novel Predictive Indicators

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