Study suggests other causes for childhood brain aneurysms

A new University of Cincinnati (UC) study questions the commonly held scientific belief that childhood brain aneurysms are caused by trauma, infection or underlying vascular malformations.

In a retrospective review of 53 Ohio children with intracranial (brain) arterial aneurysms, Todd Abruzzo, MD, found that the most common type of aneurysm among all age groups appeared to occur spontaneously—with no related trauma or infection, recognizable clinical warnings signs or underlying medical causes, such as vascular malformations.

Researchers say this data suggests unknown genetic factors, environmental exposures or an interaction of the two may predispose certain children to aneurysm development.

An aneurysm occurs when a blood vessel weakens and stretches, forming a bulge in the vessel wall that can rupture and hemorrhage. Intracranial arterial aneurysms—uncommon in pediatric patients—are bulges that develop in the arteries that carry blood to the brain.

In addition, Abruzzo reports that 75 percent of the patients whose aneurysms developed spontaneously had no risk factors for vascular disease, which in adults include smoking and high blood pressure.

“This is very significant because it provides insight into the mechanisms of aneurysm formation,” says Abruzzo, an assistant professor of radiology, neurosurgery and biomedical engineering at UC and interventional neuroradiologist at University Hospital and Cincinnati Children’s Hospital Medical Center. “Most cerebrovascular specialists believe that aneurysms arise from ‘mechanical fatigue’ of the arterial wall—resulting from wear and tear caused by a lifetime of excessive blood pressure and flow on thin-walled cerebral arteries.

“But our study suggests that—unlike the adult disease—childhood aneurysms may be driven by unique predisposing factors that we have not yet identified. It could have much less to do with underlying conditions commonly thought to contribute to their development,” he explains.

Abruzzo will present this research, believed to be one of the largest reported case series of pediatric intracranial arterial aneurysms in the United States, at 3 p.m. Wednesday, June 13, at the American Society of Neuroradiology’s annual meeting in Chicago.

For the study, the neuroradiology team reviewed epidemiological, anatomical, pathological and clinical characteristics of the 53 patients—all under age 19—at Cincinnati’s University Hospital, Cincinnati Children’s Hospital and Columbus Children’s Hospital from January 1993 to November 2006. Most of these patients had developed intracranial hemorrhage, which occurs when intracranial aneurysm ruptures.

“It turns out the aneurysms not only occurred in different places in children compared to adults, but there also appeared to be a difference in the way the disease develops,” says Abruzzo. “These differences merit further investigation to give neuroradiologists the knowledge they need to develop ongoing treatment and strategies for monitoring this at-risk population.”

Source: University of Cincinnati

Related stories:

Smokers treated for brain aneurysm with coils at higher risk of recurrence
Cigarette smokers who were treated for cerebral aneurysms with coil embolization (blocking of a blood vessel) are at greater risk of developing another aneurysm, say neurological surgeons at Jefferson Hospital for Neuroscience in Philadelphia in the first-known study of its kind.
New devices less effective in thwarting brain aneurysm recurrence
A retrospective analysis of 100 patients suffering from a ruptured brain aneurysm has found that expensive new coiling devices are no more effective than bare platinum coils at preventing aneurysms from recurring.
Jefferson neurosurgeons using new liquid treatment for wide-neck brain aneurysm
Neurological surgeons at Jefferson Hospital for Neuroscience are among the first surgeons in the United States using an FDA-approved liquid system for treating wide-necked brain aneurysms, which could eventually replace current treatments.
Rapid changes in key Alzheimer's protein described in humans
For the first time, researchers have described hour-by-hour changes in the amount of amyloid beta, a protein that is believed to play a key role in Alzheimer's disease, in the human brain. A collaborative team of scientists at Washington University School of Medicine in St. Louis and the University of Milan report their results this week in Science.
More aortic chest aneurysms being treated with less-invasive stents
An estimated 60,000 Americans are walking around with time bombs in their chests called thoracic aortic aneurysms. At any time, their main chest artery could suddenly burst open, causing massive internal bleeding that is almost always fatal.
Brain surgery is getting easier on patients
Dr. Edward Duckworth is part of a new generation of neurosurgeons who are making brain surgery a lot easier on patients. At Loyola University Hospital, Duckworth is using less-invasive techniques to remove tumors, to repair life-threatening aneurysms and to dramatically reduce seizures in epilepsy patients.
Stent grafts: a better way to treat blunt trauma injuries
Endovascular repair—fixing an injury in a blood vessel from inside that vessel—is a better option for individuals who receive highly lethal injuries from high-speed collisions or falls (together referred to as blunt trauma) and is shown to save more lives and nearly eliminate paraplegia (the loss of the ability to move and/or feel both legs), a complication of surgical repair for thoracic aortic aneurysms.
Women, Mexican-Americans at higher risk of ruptured brain aneurysm
A type of stroke that can strike at any age, and kills one-third of its victims, appears to be more common in women and Mexican-Americans than in non-Hispanic white men, according to a new study from the University of Michigan Stroke Program.

News discussion:

Medicine & Health news