Risk Factors for Cerebral Aneurysm Rupture in Mongolia

Effect of Siphon Morphology on the Risk of C7 Segment Aneurysm Formation : A Case-control CFD Study

PURPOSE

Tortuosity of the internal carotid artery (ICA) is associated with intracranial aneurysms (IAs). The siphon is the most curved segment of the ICA, but its morphology has controversial effects on IAs. This study aimed to explore the morphometric features of the siphon and the potential hemodynamic mechanisms that may affect C7 aneurysm formation.

METHODS

In this study 32 patients with C7 aneurysms diagnosed at Xiangya Hospital between 2019 and 2021 and 32 control subjects were enrolled after propensity score matching. Computed tomography angiography (CTA) images were acquired to measure morphologic features, and then, by combining clinical data, simplified carotid siphon models were constructed, and computational fluid dynamics (CFD) analysis was performed.

RESULTS

The presence of C7 aneurysms was associated with the height of the C4-C6 curved arteries (odds ratio [OR] 0.028, 95% confidence interval [CI] 0.003-0.201; P < 0.001). The heights of the C4-C6 curved arteries in the aneurysm group were significantly shorter than those in the control group. The CFD analysis revealed that shorter C4-C6 bends led to greater blood velocity and pressure in the C7 segment arteries.

CONCLUSION

A shorter C4-C6 bend was associated with distal C7 aneurysm formation, and an elaborate hemodynamic mechanism may underlie this association.

Schizandrin A attenuates early brain injury following subarachnoid hemorrhage through suppressing neuroinflammation

BACKGROUND

Early brain injury (EBI) is the vital factor in determining the outcome of subarachnoid hemorrhage (SAH). Schizandrin A (Sch A), the bioactive ingredient extracted from Schisandra chinensis, has been proved to exert beneficial effects in multiple human diseases. However, the effect of Sch A on SAH remains unknown. The current study was designed to explored role and mechanism of Sch A in the pathophysiological process of EBI following SAH.

METHOD

A total of 74 male C57BL/6 J mice were subjected to endovascular perforation to establish the SAH model. Different dosages of Sch A were administrated post-modeling. The post-modeling assessments included neurological test, brain water content, RT-PCR, immunofluorescence, Nissl staining. Oxygenated hemoglobin was introduced into microglia to establish a SAH model in vitro.

RESULT

Sch A significantly alleviated SAH-induced brain edema and neurological impairment. Moreover, application of Sch A remarkably inhibited SAH-induced neuroinflammation, evidenced by the decreased microglial activation and downregulated TNF-α, IL-1β and IL-6 and expression. Additionally, Sch A, both in vivo and in vitro, protected neurons against SAH-induced inflammatory injury. Mechanismly, administration of Sch A inhibited miR-155/NF-κB axis and attenuated neuroinflammation, as well as alleviating neuronal injury.

CONCLUSION

Our data suggested that Sch A could attenuated EBI following SAH via modulating neuroinflammation. The anti-inflammatory effect was exerted, at least partly through the miR-155/NF-κB axis, which may shed light on a possible therapeutic target for SAH.

Risk Factors and Location of Intracranial Aneurysm Rupture in a Consecutive Chinese Han Population

OBJECTIVE

The aim of the present study was to retrospectively analyze and investigate the clinical data of 704 cases of ruptured intracranial aneurysms (RIAs) and unruptured intracranial aneurysms (UIAs). The risk factors predicting aneurysm rupture were explored from the perspective of the clinical characteristics of intracranial aneurysm (IA).

METHODS

The clinical data of 704 patients with RIAs (494 patients) and UIAs (210 patients) admitted to the Department of Neurosurgery of Tianjin Medical University General Hospital and Tianjin Fifth Central Hospital between January 2016 and May 2022 were analyzed. A detailed analysis of sex, age, history, personal history, drug intake, and site of aneurysm occurrence was performed. Age was analyzed in segments and strata, and parameters with significant differences in the preliminary analysis results were analyzed by logistic regression to predict factors associated with the risk of aneurysm rupture.

RESULTS

Among 494 patients with RIA (70.2%) and 210 patients with UIA (29.8%), the logistic regression showed that IA location appeared to be the most significant factor associated with RIA (OR, 95% CI: internal carotid artery (ICA), reference; anterior communicating artery,27.864,12.548-61.878; posterior communicating artery,12.408,6.658-23.124; anterior cerebral artery,5.804,2.333-14.440; middle cerebral artery,9.284,4.599-18.744; posterior circulation arteries, 4.224,2.011-8.871). Age was not a significant factor associated with RIA in the model and Hyperlipidemia (OR: 0.365; 95% CI: 0.171-0.779), Atherosclerosis (OR: 0.277; 95% CI: 0.172-0.446) and Multiple aneurysms (OR: 0.275; 95% CI: 0.177-0.425) patients were less likely to have RIA.IA location and age were the best predictors of RIA using the model.

CONCLUSIONS

The present findings indicated that hyperlipidemia and atherosclerosis have a protective effect on aneurysm rupture, and different anatomical sites of IA may be risk factors for the occurrence of IA rupture. Among the anatomical sites of IA, the anterior communicating artery and posterior communicating artery have a higher fracture risk.