Systemic connective tissue abnormalities in patients with saccular intracranial aneurysms

Acta Neurol Scand. 2013 Aug;128(2):130-5. doi: 10.1111/ane.12088. Epub 2013 Feb 7.

Abstract

Objectives: Our purpose was to identify the incidence and significance of markers of systemic connective tissue abnormalities (CTA) in patients with saccular intracranial aneurysms (SIA).

Materials and methods: This prospective case-control study included 199 consecutive patients with SIA (103 women and 96 men, mean age - 43.2 years) and 194 control patients - blood donors (108 - men, 86 - women, mean age - 38.4 years). Aneurysms were verified by conventional cerebral angiography. All patients were examined by the first author using a specially designed questionnaire and a standardized physical examination with special emphasis on systemic CTA.

Results: Twelve markers of systemic CTA were significantly higher in patients with SIA than in controls: visible vessels on face and chest (59.8%), scoliosis (44.7%), varicose veins in legs (39.7%), flatfoot (34.6%), hyperextensibility of the skin (33.6%), spontaneous epistaxis (25.6%), easy bruising (20.6%), abdominal hernia (13.6%), periodontal disease (10.5%), chest deformations (7.5%), abdominal striae (3.5%), joint hypermobility (2.5%). A blinded validation study in a subset of 43 patients showed similar results. Among patients with SIA, 125 of 199 patients (62.8%) had at least three markers of systemic CTA compared with 23 (11.8%) of the controls (P < 0.0001, OR = 12.5, 95% CI 7.45-21.1). The mean number of markers of systemic CTA in patients with SIA was 3.07 and 1.17 in controls.

Conclusion: Patients with SIA have multiple markers of systemic connective tissue abnormalities. Systemic weakness of connective tissue represents a risk factor for development of SIA. Identification of these markers may help in detection of high-risk patients.

Keywords: connective tissue; intracranial aneurysms; markers; risk factors.

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Cerebral Angiography
  • Connective Tissue / diagnostic imaging
  • Connective Tissue / pathology*
  • Connective Tissue Diseases / complications*
  • Connective Tissue Diseases / diagnostic imaging
  • Connective Tissue Diseases / pathology*
  • Female
  • Humans
  • Intracranial Aneurysm / complications*
  • Male
  • Middle Aged
  • Odds Ratio
  • Prospective Studies
  • Retrospective Studies
  • Saccule and Utricle / pathology
  • Young Adult