Details

Autor(en) / Beteiligte

• Giotta Lucifero, Alice
• Baldoncini, Matías
• Bruno, Nunzio
• Galzio, Renato
• Hernesniemi, Juha
• Luzzi, Sabino

Titel

Shedding the Light on the Natural History of Intracranial Aneurysms: An Updated Overview

Ist Teil von

• Medicina (Kaunas, Lithuania), 2021-07, Vol.57 (8), p.742

Ort / Verlag

Basel: MDPI AG

Erscheinungsjahr

2021

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• 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.