Unruptured Intracranial Aneurysms

Hackenberg, K; Hänggi, Daniel; Etminan, Nima

doi:10.1161/strokeaha.118.021030

Cited by 99 publications

(56 citation statements)

References 47 publications

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“…Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating subtype of hemorrhagic strokes and it accounts for 5% of all strokes. The worldwide incidence of aSAH is approximately 700000 person-years; the mortality of aSAH is approximately 40% despite appropriate surgical and medical care (1,2). aSAH has a poor prognosis with significant lifelong morbidity and cognitive deficits for those who survive.…”

Section: Introductionmentioning

confidence: 99%

“…aSAH has a poor prognosis with significant lifelong morbidity and cognitive deficits for those who survive. Moreover, aSAH has a significant impact on society, as it often affects young people at the peak of their productive life (1,2). This highly fatal and morbid type of intracranial hemorrhage is due to intracranial aneurysm (ICA) rupture in nearly 85% of SAH cases (3).…”

Section: Introductionmentioning

confidence: 99%

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Vascular Macrophages as Therapeutic Targets to Treat Intracranial Aneurysms

et al. 2021

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Aneurysmal subarachnoid hemorrhage (aSAH) is a highly fatal and morbid type of hemorrhagic strokes. Intracranial aneurysms (ICAs) rupture cause subarachnoid hemorrhage. ICAs formation, growth and rupture involves cellular and molecular inflammation. Macrophages orchestrate inflammation in the wall of ICAs. Macrophages generally polarize either into classical inflammatory (M1) or alternatively-activated anti-inflammatory (M2)-phenotype. Macrophage infiltration and polarization toward M1-phenotype increases the risk of aneurysm rupture. Strategies that deplete, inhibit infiltration, ameliorate macrophage inflammation or polarize to M2-type protect against ICAs rupture. However, clinical translational data is still lacking. This review summarizes the contribution of macrophage led inflammation in the aneurysm wall and discuss pharmacological strategies to modulate the macrophageal response during ICAs formation and rupture.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Vascular Macrophages as Therapeutic Targets to Treat Intracranial Aneurysms

et al. 2021

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“…All over the world, ICH remains associated with high morbidity and mortality, and represents one of the greatest healthcare crises affecting the quality of people's life [1][2][3][4][5]. ICH is the common (consisting of 10-15% of all stroke cases) but most severe subtype of cerebral stroke, which also includes the cases suffered from ischemic and other insults [6][7][8][9]. Much progress has been made in recent years in understanding the pathogenesis of ICH [7,10].…”

Section: Introductionmentioning

confidence: 99%

Dl-3-n-Butylphthalide promotes neovascularization and neurological recovery in a rat model of intracerebral hemorrhage

Chen

Tan

et al. 2020

BMC Neurosci

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Background: Cerebral stroke occurs following ischemic and hemorrhagic lesions in the brain. Survival and recovery of stroke patients depend on the severity of the initial injury but also the therapeutic approaches applied for emergent lifesaving and continuing post-stroke management. Dl-3-n-Butylphthalide (NBP), an active compound derived from Chinese celery seeds, has shown clinical efficacy in the treatment of ischemic cerebral stroke. Results: In the present study we explored the therapeutic effect of NBP in a rat model of intracerebral hemorrhage (ICH), focusing on its potential role in promoting neovascularization in the perihemorrhagic zone. ICH was induced in male Sprague-Dawley rats by unilateral injection of autologous blood into the globus pallidus, with sham-operated (Sham group), vehicle-treated (ICH) and NBP-treated (at 10 and 25 mg/kg/Bid, p.o., ICH + NBP10 and ICH + NBP25, respectively) groups examined behaviorally, macroscopically, histologically and biochemically at 1, 3, 7 and 15 days (d) post operation. Rats in the ICH + NBP10 and ICH + NBP25 groups showed reduced Longa's motor scores relative to the ICH groups at the 3 and 7d time points, while the hematoma volume was comparable in the two NBP relative to the ICH groups as measured at 7d and 15d. In the perihemorrhagic zone, the numeric density of blood vessels immunolabeled by CD34, an angiogenic marker, was greater in the ICH + NBP10 and ICH + NBP25 than ICH groups, more so in the higher dosage group, at 1, 3, 7 and 15d. Levels of the vascular endothelial growth factor (VEGF) and angiopoietins-2 (Ang-2) proteins were elevated in the NBP groups relative to the sham and vehicle controls in immunoblotting of tissue lysates from the injection region. Conclusion: These results suggest that NBP can alleviate neurological defects following experimentally induced local brain hemorrhage, which is associated with a potential role of this drug in promoting neovascularization surrounding the bleeding loci.

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“…Unruptured, intracranial aneurysms, have a prevalence of 3% worldwide, global incidence of 700,000 person-years, and rupture rate of 0.3% per year. 1 As neuroimaging advances, more asymptomatic aneurysms are detected incidentally, which does not correlate with increased risk of rupture. 1 Why then, is management of aneurysms a highly involved process warranting a multidisciplinary approach?…”

Section: Introductionmentioning

confidence: 99%

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2020

JNSK

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Purpose: The purpose of this study was to measure sensitivity of virtual reality (VR) in detecting biomarkers of neurovascular remodeling suboptimally evaluated in digital subtraction angiography (DSA) of treated unruptured, intracranial aneurysms. Methods: The sensitivity of virtual reality and digital subtraction angiography in detection of neurovascular biomarkers in aneurysms treated with flow diversion, coiling, and clipping were evaluated. Validated grading scales were integrated into a standardized rating platform. The respective novel and conceptual measures of minimal imaging important difference (MIID) and number needed to image (NNI) were calculated for each biomarker. Results: In flow diversion, coiling, and clipping, minimal imaging important difference and number needed to image were associated with virtual reality in detection of abnormal biomarkers, with the exception of stasis phase associated with digital subtraction angiography. Number needed to image was associated with flow diversion stent stenosis (RR: 7.00, 95% CI 0.37 to 131.97; OR: 7.46, 95% CI 0.38 to 148.49). Minimal imaging important difference was greatest in residual aneurysm filling (25%±8.66, 95% CI) in flow diversion and Meyer score in coiling (42.5%±17.69, 95% CI) and clipping (22.2%±13.58, 95% CI). Regression models demonstrated minimal imaging important difference and number needed to image shared a significant correlation (R 2 0.99, 95% CI, p<0.001). Conclusion: Virtual reality adds value to digital subtraction angiography in evaluation of aneurysms treated with flow diversion, coiling, and clipping. Larger, prospective studies are warranted to increase statistical power and validate clinical significance.

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Unruptured Intracranial Aneurysms

Cited by 99 publications

References 47 publications

Vascular Macrophages as Therapeutic Targets to Treat Intracranial Aneurysms

Vascular Macrophages as Therapeutic Targets to Treat Intracranial Aneurysms

Dl-3-n-Butylphthalide promotes neovascularization and neurological recovery in a rat model of intracerebral hemorrhage

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