Inflammation and intracranial aneurysms

Neurosurgery. 1999 Nov;45(5):1137-46; discussion 1146-7. doi: 10.1097/00006123-199911000-00024.

Abstract

Objective: An intracranial aneurysm is an important acquired cerebrovascular disease that can cause a catastrophic subarachnoid hemorrhage. Despite modern therapy, most patients die or are left disabled as a direct result of a severe initial hemorrhage. The development of more effective treatment strategies depends on understanding the fundamental biology of cerebral aneurysms. The purpose of the present study is to determine whether inflammation or immunological reaction occurs in cerebral aneurysms.

Methods: Aneurysm tissue was collected at the time of microsurgical repair from 23 unruptured and 2 ruptured aneurysms (25 patients) and compared with 11 control basilar arteries harvested at autopsy. Immunohistochemistry was used to localize complement (C3c, C9), immunoglobulins (IgG, IgM), vascular cell adhesion molecule-1, macrophages and monocytes (CD68), T lymphocytes (CD3), and B lymphocytes (CD20).

Results: Complement (C3c, P < 0.0001; C9, P = 0.0017), immunoglobulin (IgG, P = 0.0013; IgM, P = 0.031), vascular cell adhesion molecule-1 (P = 0.0022), macrophages (CD68, P = 0.004), and T lymphocytes (CD3, P = 0.0004) were all frequently present in the wall of aneurysm tissue but were rarely identified in control basilar arteries. A few B lymphocytes (CD20, P = 0.41) were found in aneurysm tissue, but none were found in the basilar arteries.

Conclusion: Extensive inflammatory and immunological reactions are common in unruptured intracranial aneurysms and may be related to aneurysm formation and rupture.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aneurysm, Ruptured / immunology*
  • Aneurysm, Ruptured / pathology
  • Aneurysm, Ruptured / surgery
  • Basilar Artery / immunology
  • Basilar Artery / pathology
  • Basilar Artery / surgery
  • Complement C3c / metabolism
  • Complement C9 / metabolism
  • Female
  • Humans
  • Immunoglobulin G / metabolism
  • Immunoglobulin M / metabolism
  • Intracranial Aneurysm / immunology*
  • Intracranial Aneurysm / pathology
  • Intracranial Aneurysm / surgery
  • Macrophages / immunology
  • Macrophages / pathology
  • Male
  • Microscopy, Fluorescence
  • Middle Aged
  • Prognosis
  • Systemic Inflammatory Response Syndrome / immunology*
  • Systemic Inflammatory Response Syndrome / pathology
  • Systemic Inflammatory Response Syndrome / surgery
  • T-Lymphocytes / immunology
  • T-Lymphocytes / pathology
  • Vascular Cell Adhesion Molecule-1 / metabolism

Substances

  • Complement C9
  • Immunoglobulin G
  • Immunoglobulin M
  • Vascular Cell Adhesion Molecule-1
  • Complement C3c