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> Disorders > Disease or Syndrome > Intracranial Aneurysm

Intracranial Aneurysm

Intracranial Aneurysm: A localized, abnormal, blood-filled dilatation of a blood vessel within the cranium.
These bulging weaknesses in the arterial wall most commonly occur at the base of the brain and may result in life-threatening hemorrhage and neurological complications if left untreated.
Effective diagnosis and management of intracranial aneurysms is crucial for preventing serious complications and improving patient outcomes.

Most cited protocols related to «Intracranial Aneurysm»

1
Intracranial Aneurysm Formation in Mice
Detailed descriptions of the methods are provided in Online Data Supplement at “http://hyper.ahajournals.org.”
In order to test whether the combination treatment of single elastase injection and pharmacologically-induced hypertension can cause the formation of intracranial aneurysms in mice, we treated C57BL/6J mice (8–10 weeks old) with a single stereotaxic injection of elastase at the right basal cistern, immediately followed by induction of systemic hypertension with continuous injection of angiotensin-II. After two weeks, we sacrificed the mice and perfused the animals with a bromophenol blue dye and gelatin mixture.
Our preliminary study indicated a wide variation in vessel diameter for the Circle of Willis and its major branches in mice. In order to have a conservative and consistent control for our experiment, we used the diameter of the basilar artery–one of the larger vessels in the brain circulation with relatively little variation—as a reference blood vessel. Aneurysms were operationally defined as a localized outward bulging of the vascular wall whose diameter is greater than 150% of the basilar artery diameter. The Circle of Willis or its major primary branches were assessed by two investigators in a blinded manner.
To assess the relationship between the elastase dose and the incidence of aneurysms, four groups of mice were prepared: Group 1: 35 milli-units of heat-inactivated elastase, Group 2: PBS (n=10), Group 3: 3.5 milli-units of elastase (n=10). Group 4: 17.5 milli-units of elastase (n=20), and Group 5: 35 milli-units of elastase (n = 44). Angiotensin-II was administered at 1000 ng/kg/min for two weeks in all groups.
To assess the relationship between the angiotensin-II concentration and the incidence of aneurysms, three groups of mice were prepared: Group 1: continuous infusion of PBS via osmotic pump (n=10), Group 2: 500 ng/kg/min of angiotensin-II (n=10), Group 3: 1000 ng/kg/min of angiotensin-II (n=44). This group (Group 3) is the same as the Group 5 in the above-mentioned experiment testing the dose dependency of elastase effects. 35 milli-units of elastase were administered to all groups.
Nuki Y., Tsou T.L., Kurihara C., Kanematsu M., Kanematsu Y, & Hashimoto T. (2009). Elastase-induced intracranial aneurysms in hypertensive mice. Hypertension, 54(6), 1337-1344.
Publication 2009
Aneurysm Angiotensin II Animals Basilar Artery Blood Vessel Brain Bromphenol Blue Circle of Willis Dietary Supplements Gelatins High Blood Pressures Intracranial Aneurysm Mice, House Mice, Inbred C57BL Osmosis Pancreatic Elastase
2
Intracranial Aneurysm Induction in Hypertensive Mice
Experiments were conducted in accordance with the guidelines approved by the University of California, San Francisco, Institutional Animal Care and Use Committee.
We used the elastase-induced intracranial aneurysms in 8 to 9 week old hypertensive mice as previously described.11 (link) In this model, two well-known clinical factors associated with human intracranial aneurysms—hypertension and the disruption of elastic lamina— were combined to induce intracranial aneurysm formation in mice. We performed a single stereotaxic injection of elastase into the cerebrospinal fluid at the right basal cistern. A volume of 2.5 μL of elastase solution (17 milli-units) was injected at a rate of 0.2 μL/min (Ultramicropump, World Precision Instruments). Hypertension was induced by a continuous subcutaneous infusion of angiotensin-II at 1000 ng/kg/min for three weeks via an implanted osmotic pump (Alzet pump, Durect).11 (link), 14 (link)
Systolic blood pressure was measured in mice before treatment, one week after elastase injection, and two weeks after elastase injection using the tail cuff method. After three weeks, we sacrificed the mice and perfused the animals with bromophenol blue dye. Two blinded observers assessed the formation of intracranial aneurysms by examining of Circle of Willis and its major branches under a dissecting microscope (10×). Intracranial aneurysms were operationally defined as a localized outward bulging of the vascular wall in the Circle of Willis or in its major primary branches, as previously described.10 (link), 11 (link) After inspecting the Circle of Willis, the whole brain samples were frozen in OCT for immunohistochemical staining.
Kanematsu Y., Kanematsu M., Kurihara C., Tada Y., Tsou T.L., van Rooijen N., Lawton M.T., Young W.L., Liang E.I., Nuki Y, & Hashimoto T. (2010). Critical roles of macrophages in the formation of intracranial aneurysm. Stroke; a journal of cerebral circulation, 42(1), 173-178.
Publication 2010
Aneurysm Angiotensin II Animals Blood Vessel Brain Bromphenol Blue Cerebrospinal Fluid Circle of Willis Freezing High Blood Pressures Homo sapiens Institutional Animal Care and Use Committees Intracranial Aneurysm Microscopy Mus Osmosis Pancreatic Elastase pancreatic elastase II Subcutaneous Infusions Systolic Pressure Tail
3
Genetic Correlates of Intracranial Aneurysms
We assessed correlation between intracranial aneurysms and other traits using LDHub and LD-score regression (LDSR) with LDSC. To assess genetic correlation between intracranial aneurysms and many non-stroke-related traits, we used LD Hub41 (link)
. This platform uses LDSR to assess genetic correlation with a large number of publicly available GWASs. For the correlation of intracranial aneurysms and other stroke subtypes, we obtained summary statistics for All Stroke (AS), Cardioembolic Stroke (CE), Any Ischemic Stroke (AnyIS), Large Artery Stroke (LAS), Small Vessel Disease (SVD)42 (link)
, Deep, Lobar, and combined Intracerebral Hemorrhage (ICH)63 (link)
, carotid- and vertebral artery dissection44 (link)
, Arteriovenous Malformation (AVM)43 (link)
 and Abdominal Aortic Aneurysms (AAA)45 (link)
. We used LDSC to calculate genetic correlation. LD scores from European ancestry individuals from 1000G were calculated for SNPs in the HapMap 3 SNP set and used to calculate genetic correlation. Since the heritability estimate was negative for AVM, due to the small sample size, we performed a SNP lookup of the Stage 2 intracranial aneurysm loci that passed the multiple testing threshold (P<5·10-8) from the GWAS of AVM43 (link)
.
Bakker M.K., van der Spek R.A., van Rheenen W., Morel S., Bourcier R., Hostettler I.C., Alg V.S., van Eijk K.R., Koido M., Akiyama M., Terao C., Matsuda K., Walters R.G., Lin K., Li L., Millwood I.Y., Chen Z., Rouleau G.A., Zhou S., Rannikmäe K., Sudlow C.L., Houlden H., van den Berg L.H., Dina C., Naggara O., Gentric J.C., Shotar E., Eugène F., Desal H., Winsvold B.S., Børte S., Johnsen M.B., Brumpton B.M., Sandvei M.S., Willer C.J., Hveem K., Zwart J.A., Verschuren W.M., Friedrich C.M., Hirsch S., Schilling S., Dauvillier J., Martin O., Jones G.T., Bown M.J., Ko N.U., Kim H., Coleman J.R., Breen G., Zaroff J.G., Klijn C.J., Malik R., Dichgans M., Sargurupremraj M., Tatlisumak T., Amouyel P., Debette S., Rinkel G.J., Worrall B.B., Pera J., Slowik A., Gaál-Paavola E.I., Niemelä M., Jääskeläinen J.E., von Und Zu Fraunberg M., Lindgren A., Broderick J.P., Werring D.J., Woo D., Redon R., Bijlenga P., Kamatani Y., Veldink J.H, & Ruigrok Y.M. (2020). Genome-wide association study of intracranial aneurysms identifies 17 risk loci and genetic overlap with clinical risk factors. Nature genetics, 52(12), 1303-1313.
Publication 2020
Aortic Aneurysm, Abdominal Arteries Arteriovenous Malformation Cardioembolic Stroke Carotid Arteries Cerebral Hemorrhage Cerebrovascular Accident Europeans Genome-Wide Association Study HapMap Intracranial Aneurysm Reproduction Stroke, Ischemic Vascular Diseases Vertebral Artery
4
Mouse Model of Intracranial Aneurysm Formation
Experiments were conducted in accordance with the guidelines approved by the University of California, San Francisco, Institutional Animal Care and Use Committee. Intracranial aneurysms were induced in 8–10 week-old male mice (C57BL/6J, Jackson Laboratory) using a previously described method with modifications.7 (link), 13 (link) We combined induced systemic hypertension and a single injection of elastase into the cerebrospinal fluid at the right basal cistern. (Detailed methods are presented in the online supplements.)To induce systemic hypertension, we used deoxycorticosterone acetate-salt hypertension (DOCA-salt hypertension).14 (link) Mice underwent nephrectomy followed by an implantation of DOCA pellet one week later; 1% sodium chloride drinking water was started on the same day as the DOCA pellet implantation.14 (link), 15 (link) Mice received a single injection of elastase (25–35 milli-units) into the cerebrospinal fluid at the right basal cistern on the same day as DOCA pellet implantation.7 (link), 13 (link) Aneurysms were defined as a localized outward bulging of the vascular wall, whose diameter was greater than the parent artery diameter.7 (link), 13 (link)Two blinded observers performed daily neurological examination using a previously described method with modifications.16 (link)–19 (link) Neurological symptoms were scored as followings; 0: normal function; 1: reduced eating or drinking activity demonstrated by a weight loss greater than two grams of body weight (approximately 10% weight loss) over 24 hours; 2: flexion of the torso and forelimbs upon lifting of the whole animal by the tail; 3: circling to one side with a normal posture at rest; 4: leaning to one side at rest; 5: no spontaneous activity. Mice were sacrificed when they developed neurological symptoms (score 1–5). All asymptomatic mice were sacrificed 28 days after aneurysm induction. The brain samples were perfused with phosphate-buffered saline, followed by a gelatin containing blue dye in order to visualize cerebral arteries, as well as to assess for aneurysm formation and subarachnoid hemorrhage.
Makino H., Tada Y., Wada K., Liang E.I., Chang M., Mobashery S., Kanematsu Y., Kurihara C., Palova E., Kanematsu M., Kitazato K, & Hashimoto T. (2012). Pharmacological stabilization of intracranial aneurysms in mice— a feasibility study. Stroke; a journal of cerebral circulation, 43(9), 2450-2456.
Publication 2012
Aneurysm Animals Arteries Blood Vessel Body Weight Brain Cerebral Arteries Cerebrospinal Fluid Desoxycorticosterone Acetate Dietary Supplements Forelimb Gelatins High Blood Pressures Institutional Animal Care and Use Committees Intracranial Aneurysm Males Mus Nephrectomy Neurologic Examination Neurologic Symptoms Ovum Implantation Pancreatic Elastase Parent Phosphates Saline Solution Sodium Chloride Subarachnoid Hemorrhage Tail Torso
5
Unruptured Intracranial Aneurysm Incidence
Primary outcomes were the incidence of unruptured intracranial aneurysms and the rupture rate (number of mice with ruptured aneurysm/number of mice with ruptured or unruptured aneurysms). We used Fisher’s exact test for the analysis of primary outcomes. As an exploratory analysis, the survival analysis was performed using the Log-rank test. Mice that did not develop aneurysms were excluded in the survival analysis. Blood pressure and body weight were analyzed by ANOVA, followed by the Tukey-Kramer post hoc test. All of the results were expressed as mean ± SD. Statistical significance was considered at P < 0.05.
Tada Y., Wada K., Shimada K., Makino H., Liang E.I., Murakami S., Kudo M., Kitazato K.T., Nagahiro S, & Hashimoto T. (2013). Roles of hypertension in the rupture of intracranial aneurysms. Stroke; a journal of cerebral circulation, 45(2), 579-586.
Publication 2013
Aneurysm Aneurysm, Ruptured Blood Pressure Body Weight Intracranial Aneurysm Mus neuro-oncological ventral antigen 2, human

Most recents protocols related to «Intracranial Aneurysm»

1
Characterizing Idiopathic Normal Pressure Hydrocephalus
The study design and protocol have been approved by the ethics committees for human research at our institute (IRB number: R2019-227). This study followed a prospective and observational design. The study was performed in accordance with the approved guidelines of the Declaration of Helsinki. From November 2020 to February 2022, 133 healthy volunteers aged ≥ 20 years underwent MRI after providing written informed consent explaining the potential for detection of brain disease. Volunteers were recruited from medical staff and students, and their families by open recruitment. Inclusion criteria for this study were those who had no history of brain injury, brain tumor or cerebrovascular disease on previous brain MRI, or those who had never undergone brain MRI and no neurological symptoms including cognitive function. One volunteer aged 84 years old was excluded from this study because of a history of head surgery due to a head injury over 30 years ago. In addition, three volunteers were incidentally found small unruptured intracranial aneurysms with a maximum diameter of < 2 mm on this MRI. They were included in this study, because small unruptured aneurysms might not affect CSF motion.
Patients’ MRI data was used in an opt-out method, after their personal information was anonymized in a linkable manner. Among 44 patients suspected with NPH, 5 patients diagnosed with secondary NPH [29 (link)] that developed after subarachnoid hemorrhage [3 (link)], intracerebral hemorrhage [1 (link)], and severe meningitis [1 (link)], and 3 patients diagnosed with congenital/developmental etiology NPH [30 (link)] were excluded from this study. Finally, 36 patients diagnosed with iNPH who had radiological findings of disproportionately enlarged subarachnoid space hydrocephalus (DESH) [31 (link)], specifically ventricular dilatation, enlarged Sylvian fissure, and narrow sulci at the high convexity, and triad symptoms of gait disturbance, cognitive impairment, and/or urinary incontinence were included in this study, according to the Japanese guidelines for management of iNPH [32 (link)]. Of them, 18 patients (50%) underwent CSF removal in 30–35 ml via a lumbar tap and were evaluated for changes in their symptoms before, one day and two days after the CSF tap test. In addition, 21 patients (86%) underwent CSF shunt surgery and their symptoms improved by ≥ 1 point on the modified Rankin Scale and/or the Japanese iNPH grading scale [32 (link)].
Yamada S., Hiratsuka S., Otani T., Ii S., Wada S., Oshima M., Nozaki K, & Watanabe Y. (2023). Usefulness of intravoxel incoherent motion MRI for visualizing slow cerebrospinal fluid motion. Fluids and Barriers of the CNS, 20, 16.
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Publication 2023
Aneurysm Brain Brain Diseases Brain Injuries Brain Neoplasms Cerebral Hemorrhage Cognition Craniocerebral Trauma Dilatation Disorders, Cognitive Ethics Committees Head Healthy Volunteers Heart Ventricle Homo sapiens Hydrocephalus Intracranial Aneurysm Japanese Lumbar Region Medical Staff Meningitis Neurologic Symptoms Operative Surgical Procedures Patients Shunt, Cerebrospinal Fluid Student Subarachnoid Hemorrhage Subarachnoid Space Triad resin Urinary Incontinence Voluntary Workers X-Rays, Diagnostic
2
Nonemergent EIB for LAA Retrospective Review
The medical data of patients who underwent nonemergent EIB for LAA between January 2006 and January 2020 were retrospectively reviewed under the approval of the Seoul National University Bundang Hospital institutional review board (IRB number: B-2103/673-103). The requirement to obtain informed consent from the patients has been waived by the Seoul National University Bundang Hospital institutional review board, and all methods were performed in accordance with the relevant guidelines and regulations. During the research period, we performed a total of 1,091 EIB procedures. A total of 738 patients who underwent EIB due to moyamoya disease or intracranial aneurysm or who underwent urgent or emergent bypass for AIS in the acute period or for acute ischemic symptoms such as transient ischemic attack (TIA) with an onset within 4 weeks were excluded. Among the remaining 272 patients, 186 whose perfusion data could not be reconstructed with RAPID software or who did not undergo pre- and immediate postoperative CTP scans were additionally excluded. Finally, 86 patients were analyzed in this study (Fig. 1).

Flow diagram of the enrolled patients.

Jo H., Lee S.U., Jeong H.G., Kim Y.D., Kim T., Sunwoo L., Ban S.P., Bang J.S., Kwon O, & Oh C.W. (2023). Long-term outcomes and quantitative radiologic analysis of extracranial–intracranial bypass for hemodynamically compromised chronic large artery occlusive disease. Scientific Reports, 13, 3717.
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Publication 2023
Ethics Committees, Research Intracranial Aneurysm Moyamoya disease 1 Patients Perfusion Radionuclide Imaging Transient Ischemic Attack
3
Cohort Study of Acute Spontaneous ICH
This real-world, retrospective cohort study was conducted of patients with first-ever acute spontaneous ICH admitted to the Affiliated Hospital of Jiujiang University (Jiujiang, China) diagnosed via head computed tomography (CT) scans from January 2021 to May 2022. All patients were hospitalized within 24 h after stroke, and their hematomas were received non-operative treatment. The exclusion criteria were: (1) less than 18 years old; (2) surgical treatment indicated; (3) ICH resulting from TBI, hemorrhagic transformation of cerebral infarction, intracranial aneurysm, intracranial tumors, arteriovenous malformation, venous sinus thrombosis, or moyamoya disease; (4) pre-ICH modified Rankin scale (mRS) ≥ 2; and (5) other specific conditions, such as severe infections within recent a month, known malignancies, and autoimmune diseases. At the same time, a group of healthy volunteers matched in age and gender were selected as controls. The control group underwent routine laboratory tests, and had no history of surgery and other diseases such as hypertension, diabetes mellitus, malignancies, and stroke. This study was approved by the Institutional Review Boards at Affiliated Hospital of Jiujiang University (Grant No. IRB2022-JJU-032-21). The written informed consent for participating was signed by patients or their immediate family members and controls themselves.
Wu M., Chen K., Jiang M., Xie F., Cao X., Chen L., Chen Z, & Yin X. (2023). High plasma complement C4 levels as a novel predictor of clinical outcome in intracerebral hemorrhage. Frontiers in Aging Neuroscience, 15, 1103278.
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Publication 2023
Arteriovenous Malformation Autoimmune Diseases CASP4 protein, human Cerebral Hemorrhage Cerebrovascular Accident Diabetes Mellitus Ethics Committees, Research Family Member Gender Head Healthy Volunteers Hematoma High Blood Pressures Infarction Infection Intracranial Aneurysm Malignant Neoplasms Moyamoya disease 1 Neoplasms, Intracranial Operative Surgical Procedures Patients Radionuclide Imaging Sinuses, Nasal Sinus Thrombosis, Intracranial Veins Venous Thrombosis X-Ray Computed Tomography
4
Unruptured ICA Aneurysms Treated with FD Stents
This is a retrospective, single-center, observational study evaluating patients diagnosed with unruptured intracranial internal carotid artery (ICA) aneurysms treated with an FD stent between January 1, 2014, and January 1, 2020, at the Fundación Oftalmológica de Santander–Clínica Ardila Lülle. We analyzed and anonymized patient information that may identify a patient from clinical records, medical consultations, and follow-up imaging records of the patients enrolled. Patients over 18 years of age with a diagnosis of unruptured small (<5 mm), medium (5–10 mm), large (10–25 mm), or giant (>25 mm) aneurysms of the intracranial internal carotid segment treated with FDs in that period were included. In addition, 1-year digital subtraction angiography (DSA) results were mandatory to assess the occlusion rate. Incomplete data in the database, patients with no follow-up, and a history of aneurysm rupture less than 30 days before treatment were excluded.
López-Callejas O., Ortiz-Giraldo A.F., Vera D.D., Ramirez-Rojas D.A., Villamizar-Barahona A.B., Ferreira-Prada C.A., Galvis M., Vargas-Pérez O., Serrano-Gómez S., Reyes-Gonzalez A, & Mantilla D. (2023). Flow Diverter Treatment for Non-Ruptured Carotid Aneurysms: Efficacy and Safety. Neurointervention, 18(1), 23-29.
Publication 2023
Aneurysm Angiography, Digital Subtraction Carotid Arteries Dental Occlusion Diagnosis Gigantism Internal Carotid Arteries Intracranial Aneurysm Patients Stents
5
Unruptured Intracranial Aneurysm Evaluation
Approval for this study was obtained from our institutional review board, and consent was obtained from all subjects. Seventy-three hospitalized and surgically treated adult patients were retrospectively evaluated from January 2019 to January 2022, and hospitalized adults diagnosed with unruptured intracranial aneurysms matched for sex and age served as the control group. All enrolled subjects underwent thin-layer CT and PC-MRI examinations of the neck. All data were measured preoperatively.
The inclusion criteria were as follows:
The exclusion criteria were as follows:
Wang S., Zhang D., Wu K., Fan W, & Fan T. (2023). Potential association among posterior fossa bony volume and crowdedness, tonsillar hernia, syringomyelia, and CSF dynamics at the craniocervical junction in Chiari malformation type I. Frontiers in Neurology, 14, 1069861.
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Publication 2023
Adult Ethics Committees, Research Intracranial Aneurysm Neck Operative Surgical Procedures Patients Physical Examination

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More about "Intracranial Aneurysm"

Intracranial aneurysms are localized, abnormal, blood-filled dilations of blood vessels within the cranium, commonly occurring at the base of the brain.
These weaknesses in the arterial wall can lead to life-threatening hemorrhage and neurological complications if left untreated.
Effective diagnosis and management of intracranial aneurysms is crucial for preventing serious outcomes and improving patient health.
Researchers can leverage various tools and technologies to enhance their intracranial aneurysm studies.
The Neuroform Atlas is a stent system used for the treatment of wide-neck intracranial aneurysms.
The HumanHT-12 V4.0 expression beadchip can be used for gene expression analysis, while SPSS 21.0 is a statistical software package that can aid in data analysis.
The Tim Trio MRI system and Human Genome U133 Plus 2.0 Array can also be valuable for imaging and genomic research, respectively.
In addition, the CT750HD, Espree, and LSM 710 confocal microscope can provide high-quality imaging capabilities, while the NanoDrop ND-1000 can be used for nucleic acid and protein quantification.
The Allura Clarity system offers advanced angiography solutions for the diagnosis and treatment of intracranial aneurysms.
By utilizing these tools and technologies, researchers can optimize their intracranial aneurysm studies, improve reproducibility, and enhance the accuracy of their findings.
Ths can lead to better understanding of the underlying mechanisms, more effective diagnostic approaches, and improved patient outcomes.