Shedding the Light on the Natural History of Intracranial Aneurysms: An Updated Overview
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 end...
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| Format: | Article |
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MDPI AG
2021-07-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/57/8/742 |
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| author | Alice Giotta Lucifero Matías Baldoncini Nunzio Bruno Renato Galzio Juha Hernesniemi Sabino Luzzi |
| author_facet | Alice Giotta Lucifero Matías Baldoncini Nunzio Bruno Renato Galzio Juha Hernesniemi Sabino Luzzi |
| author_sort | Alice Giotta Lucifero |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-10T08:37:31Z |
| format | Article |
| id | doaj.art-d4366837a82f40169bd2c96dded1cc08 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T08:37:31Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-d4366837a82f40169bd2c96dded1cc082023-11-22T08:35:25ZengMDPI AGMedicina1010-660X1648-91442021-07-0157874210.3390/medicina57080742Shedding the Light on the Natural History of Intracranial Aneurysms: An Updated OverviewAlice Giotta Lucifero0Matías Baldoncini1Nunzio Bruno2Renato Galzio3Juha Hernesniemi4Sabino Luzzi5Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, ItalyDepartment of Neurological Surgery, Hospital San Fernando, Buenos Aires 1646, ArgentinaDivision of Neurosurgery, Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, 70124 Bari, ItalyNeurosurgery Unit, Maria Cecilia Hospital, 48032 Cotignola, ItalyJuha Hernesniemi International Center for Neurosurgery, Henan Provincial People’s Hospital, Zhengzhou 450000, ChinaNeurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, ItalyThe 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.https://www.mdpi.com/1648-9144/57/8/742endothelial disfunctioninflammatory cascadeintra-aneurysmal flowintracranial aneurysmsubarachnoid hemorrhagewall shear stress |
| spellingShingle | Alice Giotta Lucifero Matías Baldoncini Nunzio Bruno Renato Galzio Juha Hernesniemi Sabino Luzzi Shedding the Light on the Natural History of Intracranial Aneurysms: An Updated Overview Medicina endothelial disfunction inflammatory cascade intra-aneurysmal flow intracranial aneurysm subarachnoid hemorrhage wall shear stress |
| title | Shedding the Light on the Natural History of Intracranial Aneurysms: An Updated Overview |
| title_full | Shedding the Light on the Natural History of Intracranial Aneurysms: An Updated Overview |
| title_fullStr | Shedding the Light on the Natural History of Intracranial Aneurysms: An Updated Overview |
| title_full_unstemmed | Shedding the Light on the Natural History of Intracranial Aneurysms: An Updated Overview |
| title_short | Shedding the Light on the Natural History of Intracranial Aneurysms: An Updated Overview |
| title_sort | shedding the light on the natural history of intracranial aneurysms an updated overview |
| topic | endothelial disfunction inflammatory cascade intra-aneurysmal flow intracranial aneurysm subarachnoid hemorrhage wall shear stress |
| url | https://www.mdpi.com/1648-9144/57/8/742 |
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