Growth and rupture of an intracranial aneurysm: the role of wall aneurysmal enhancement and CD68+
IntroductionIntracranial aneurysms occur in 3%–5% of the general population. While the precise biological mechanisms underlying the formation, growth, and sudden rupture of intracranial aneurysms remain partially unknown, recent research has shed light on the potential role of inflammation in aneury...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-09-01
|
| Series: | Frontiers in Surgery |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1228955/full |
| _version_ | 1797691118977024000 |
|---|---|
| author | Delia Cannizzaro Delia Cannizzaro Ismail Zaed Simone Olei Bethania Fernandes Simone Peschillo Davide Milani Andrea Cardia |
| author_facet | Delia Cannizzaro Delia Cannizzaro Ismail Zaed Simone Olei Bethania Fernandes Simone Peschillo Davide Milani Andrea Cardia |
| author_sort | Delia Cannizzaro |
| collection | DOAJ |
| description | IntroductionIntracranial aneurysms occur in 3%–5% of the general population. While the precise biological mechanisms underlying the formation, growth, and sudden rupture of intracranial aneurysms remain partially unknown, recent research has shed light on the potential role of inflammation in aneurysm development and rupture. In addition, there are ongoing investigations exploring the feasibility of employing new drug therapies for controlling the risk factors associated with aneurysms. CD68, a glycosylated glycoprotein and the human homolog of macrosialin, is prominently expressed in monocyte/macrophages within inflamed tissues and has shown potential application in oncology. An observational study was conducted with the aim of comparing the histological characteristics of aneurysm walls with preoperative MRI scans, specifically focusing on CD68 activity.MethodAn observational pilot study was conducted to investigate the histological characteristics of the aneurysm wall that could be potentially associated with aneurysm growth and rupture. A total of 22 patients diagnosed with ruptured and unruptured intracranial aneurysms who had undergone conventional clipping between January 2017 and December 2022 were included in the study.ResultsA histopathological analysis of the aneurysm wall was performed in all patients, particularly focusing on the presence of CD68. A preoperative MRI with gadolinium was conducted in 10 patients with unruptured aneurysms and six patients with ruptured aneurysms. An emergency clipping was performed in the remaining six patients. The results showed that CD68 positivity and wall enhancement were significantly associated with intracranial aneurysm wall degeneration, growth, and rupture.ConclusionThe histological and radiological inflammatory findings observed in the wall of cerebral aneurysms, as well as the CD68 positivity, are significantly associated with the risk of intracranial aneurysm growth and rupture. This study highlights the crucial importance of considering clinical and medical data when making treatment decisions for intracranial aneurysms. Furthermore, it emphasizes the relevance of evaluating wall enhancement in MRI scans as part of the diagnostic and prognostic process. |
| first_indexed | 2024-03-12T02:08:47Z |
| format | Article |
| id | doaj.art-043166b4a6634389ad764da15e51ded7 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-03-12T02:08:47Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-043166b4a6634389ad764da15e51ded72023-09-06T16:12:20ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-09-011010.3389/fsurg.2023.12289551228955Growth and rupture of an intracranial aneurysm: the role of wall aneurysmal enhancement and CD68+Delia Cannizzaro0Delia Cannizzaro1Ismail Zaed2Simone Olei3Bethania Fernandes4Simone Peschillo5Davide Milani6Andrea Cardia7Department of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Milan, ItalyDepartment of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale, Lugano, SwitzerlandDepartment of Biomedical Sciences, Humanitas University, Milan, ItalyDepartment of Pathology, IRCCS Humanitas Research Hospital, Milan, ItalyUnicamillus-Saint Camillus International University of Health Sciences, Rome, ItalyDepartment of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale, Lugano, SwitzerlandDepartment of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale, Lugano, SwitzerlandIntroductionIntracranial aneurysms occur in 3%–5% of the general population. While the precise biological mechanisms underlying the formation, growth, and sudden rupture of intracranial aneurysms remain partially unknown, recent research has shed light on the potential role of inflammation in aneurysm development and rupture. In addition, there are ongoing investigations exploring the feasibility of employing new drug therapies for controlling the risk factors associated with aneurysms. CD68, a glycosylated glycoprotein and the human homolog of macrosialin, is prominently expressed in monocyte/macrophages within inflamed tissues and has shown potential application in oncology. An observational study was conducted with the aim of comparing the histological characteristics of aneurysm walls with preoperative MRI scans, specifically focusing on CD68 activity.MethodAn observational pilot study was conducted to investigate the histological characteristics of the aneurysm wall that could be potentially associated with aneurysm growth and rupture. A total of 22 patients diagnosed with ruptured and unruptured intracranial aneurysms who had undergone conventional clipping between January 2017 and December 2022 were included in the study.ResultsA histopathological analysis of the aneurysm wall was performed in all patients, particularly focusing on the presence of CD68. A preoperative MRI with gadolinium was conducted in 10 patients with unruptured aneurysms and six patients with ruptured aneurysms. An emergency clipping was performed in the remaining six patients. The results showed that CD68 positivity and wall enhancement were significantly associated with intracranial aneurysm wall degeneration, growth, and rupture.ConclusionThe histological and radiological inflammatory findings observed in the wall of cerebral aneurysms, as well as the CD68 positivity, are significantly associated with the risk of intracranial aneurysm growth and rupture. This study highlights the crucial importance of considering clinical and medical data when making treatment decisions for intracranial aneurysms. Furthermore, it emphasizes the relevance of evaluating wall enhancement in MRI scans as part of the diagnostic and prognostic process.https://www.frontiersin.org/articles/10.3389/fsurg.2023.1228955/fullaneurysmsinflammationvessel wallwall enhancementvascular malformationtechnique |
| spellingShingle | Delia Cannizzaro Delia Cannizzaro Ismail Zaed Simone Olei Bethania Fernandes Simone Peschillo Davide Milani Andrea Cardia Growth and rupture of an intracranial aneurysm: the role of wall aneurysmal enhancement and CD68+ Frontiers in Surgery aneurysms inflammation vessel wall wall enhancement vascular malformation technique |
| title | Growth and rupture of an intracranial aneurysm: the role of wall aneurysmal enhancement and CD68+ |
| title_full | Growth and rupture of an intracranial aneurysm: the role of wall aneurysmal enhancement and CD68+ |
| title_fullStr | Growth and rupture of an intracranial aneurysm: the role of wall aneurysmal enhancement and CD68+ |
| title_full_unstemmed | Growth and rupture of an intracranial aneurysm: the role of wall aneurysmal enhancement and CD68+ |
| title_short | Growth and rupture of an intracranial aneurysm: the role of wall aneurysmal enhancement and CD68+ |
| title_sort | growth and rupture of an intracranial aneurysm the role of wall aneurysmal enhancement and cd68 |
| topic | aneurysms inflammation vessel wall wall enhancement vascular malformation technique |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1228955/full |
| work_keys_str_mv | AT deliacannizzaro growthandruptureofanintracranialaneurysmtheroleofwallaneurysmalenhancementandcd68 AT deliacannizzaro growthandruptureofanintracranialaneurysmtheroleofwallaneurysmalenhancementandcd68 AT ismailzaed growthandruptureofanintracranialaneurysmtheroleofwallaneurysmalenhancementandcd68 AT simoneolei growthandruptureofanintracranialaneurysmtheroleofwallaneurysmalenhancementandcd68 AT bethaniafernandes growthandruptureofanintracranialaneurysmtheroleofwallaneurysmalenhancementandcd68 AT simonepeschillo growthandruptureofanintracranialaneurysmtheroleofwallaneurysmalenhancementandcd68 AT davidemilani growthandruptureofanintracranialaneurysmtheroleofwallaneurysmalenhancementandcd68 AT andreacardia growthandruptureofanintracranialaneurysmtheroleofwallaneurysmalenhancementandcd68 |