Pathophysiological Mechanisms for Intracranial Aneurysms.

Huang, Ziyuan; Ling, Cong · World Neurosurg · 2025

review · Level V

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Abstract

Intracranial aneurysms (IAs) represent a prevalent cerebrovascular disorder characterized by localized abnormal dilation of cerebral arterial walls. Although the majority of IAs remain clinically asymptomatic, their rupture can lead to subarachnoid hemorrhage, resulting in severe disability or even mortality. With advancements in modern imaging technologies, an increasing number of unruptured aneurysms are being detected, with an estimated prevalence of 2% to 3% in the adult population. The formation of IAs involves a complex interplay of genetic, environmental, and pathophysiological factors. This review comprehensively examines the pathophysiological mechanisms underlying IAs, including vascular wall abnormalities, hemodynamic alterations, and inflammatory responses. Although surgical interventions, such as aneurysm clipping and endovascular coil embolization, remain the primary treatment modalities, their associated complication rates remain significant. Consequently, the development of noninvasive therapeutic strategies, particularly those targeting pharmacological interventions, is of paramount importance. Future research should focus on precision medicine approaches based on individual genetic and hemodynamic profiles to enhance treatment efficacy and patient outcomes.

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