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2016 ; 56
(9
): 552-68
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Preemptive Medicine for Cerebral Aneurysms
#MMPMID27053328
Aoki T
; Nozaki K
Neurol Med Chir (Tokyo)
2016[Sep]; 56
(9
): 552-68
PMID27053328
show ga
Most of cerebral aneurysms (CAs) are incidentally discovered without any
neurological symptoms and the risk of rupture of CAs is relatively higher in
Japanese population. The goal of treatments for patients with CAs is complete
exclusion of the aneurysmal rupture risk for their lives. Since two currently
available major treatments, microsurgical clipping and endovascular coiling, have
inherent incompleteness to achieve cure of CAs with some considerable treatment
risks, and there is no effective surgical or medical intervention to inhibit the
formation of CAs in patients with ruptured and unruptured CAs, new treatment
strategies with lower risk and higher efficacy should be developed to prevent the
formation, growth, and rupture of CAs. Preemptive medicine for CAs should be
designed to prevent or delay the onset of symptoms from CAs found in an
asymptomatic state or inhibit the de novo formation of CAs, but we have no
definite methods to distinguish rupture-prone aneurysms from rupture-resistant
ones. Recent advancements in the research of CAs have provided us with some
clues, and one of the new treatment strategies for CAs will be developed based on
the findings that several inflammatory pathways may be involved in the formation,
growth, and rupture of CAs. Preemptive medicine for CAs will be established with
specific biomarkers and imaging modalities which can sensor the development of
CAs.
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