Shedding the Light on the Natural History of Intracranial Aneurysms: An Updated Overview.
endothelial disfunction
inflammatory cascade
intra-aneurysmal flow
intracranial aneurysm
subarachnoid hemorrhage
wall shear stress
Journal
Medicina (Kaunas, Lithuania)
ISSN: 1648-9144
Titre abrégé: Medicina (Kaunas)
Pays: Switzerland
ID NLM: 9425208
Informations de publication
Date de publication:
22 Jul 2021
22 Jul 2021
Historique:
received:
12
06
2021
revised:
19
07
2021
accepted:
20
07
2021
entrez:
27
8
2021
pubmed:
28
8
2021
medline:
1
9
2021
Statut:
epublish
Résumé
The exact molecular pathways underlying the multifactorial natural history of intracranial aneurysms (IAs) are still largely unknown, to the point that their understanding represents an imperative challenge in neurovascular research. Wall shear stress (WSS) promotes the genesis of IAs through an endothelial dysfunction causing an inflammatory cascade, vessel remodeling, phenotypic switching of the smooth muscle cells, and myointimal hyperplasia. Aneurysm growth is supported by endothelial oxidative stress and inflammatory mediators, whereas low and high WSS determine the rupture in sidewall and endwall IAs, respectively. Angioarchitecture, age older than 60 years, female gender, hypertension, cigarette smoking, alcohol abuse, and hypercholesterolemia also contribute to growth and rupture. The improvements of aneurysm wall imaging techniques and the implementation of target therapies targeted against inflammatory cascade may contribute to significantly modify the natural history of IAs. This narrative review strives to summarize the recent advances in the comprehension of the mechanisms underlying the genesis, growth, and rupture of IAs.
Identifiants
pubmed: 34440948
pii: medicina57080742
doi: 10.3390/medicina57080742
pmc: PMC8400479
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
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