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Prevalence of cerebral aneurysm in patients with acromegaly

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Abstract

The prevalence of cerebral aneurysm was retrospectively investigated in 208 patients with acromegaly relative to the rate of cerebral aneurysm in a group of control subjects. Neuroradiological examinations of the cerebral vascular system were conducted in 208 acromegaly patients (101 men; mean age, 48.8 years). The prevalence of cerebral aneurysm in the acromegaly patients was compared to that in a control group consisting of 7,390 subjects who underwent “brain checkup” between 2006 and 2008 (mean age, 51.6 years). In the acromegaly group, cerebral aneurysm was detected in 4.3 % of patients. By sex, the prevalence was 6.9 % in males, a significantly proportion than that in the control group with an odds ratio of 4.40. The prevalence in females did not differ between the two groups. In the acromegaly group, the rate of hypertension was significantly higher in the patients with aneurysm compared to those without aneurysm. Multiple logistic regression identified acromegaly as a significant factor related to the prevalence of cerebral aneurysm in all male subjects; other factors, such as age, hypertension and smoking, were not found to be significant. A significantly higher prevalence of cerebral aneurysm was detected in male patients with acromegaly. This finding indicates that excess growth hormone or insulin-like growth factor 1 affects the cerebral vascular wall, resulting in aneurysm formation. In addition to known systematic complications in the cardiovascular, respiratory, metabolic, and other systems, the risk of cerebral aneurysm should be considered in the management of acromegaly.

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References

  1. Colao A, Ferone D, Marzullo P, Lombardi G (2004) Systemic complications of acromegaly: epidemiology, pathogenesis, and management. Endocr Rev 25(1):102–152

    Article  PubMed  CAS  Google Scholar 

  2. Jakubowski J, Kendall B (1978) Coincidental aneurysms with tumours of pituitary origin. J Neurol Neurosurg Psychiatry 41(11):972–979

    Article  PubMed  CAS  Google Scholar 

  3. Acqui M, Ferrante L, Fraioli B, Cosentino F, Fortuna A, Mastronardi L (1987) Association between intracranial aneurysms and pituitary adenomas. A Etiopathogenetic hypotheses. Neurochirurgia (Stuttg) 30(6):177–181

    CAS  Google Scholar 

  4. Pant B, Arita K, Kurisu K, Tominaga A, Eguchi K, Uozumi T (1997) Incidence of intracranial aneurysm associated with pituitary adenoma. Neurosurg Rev 20(1):13–17

    Article  PubMed  CAS  Google Scholar 

  5. Weir B (1992) Pituitary tumors and aneurysms: case report and review of the literature. Neurosurgery 30(4):585–591

    Article  PubMed  CAS  Google Scholar 

  6. Zatelli MC, Scanarini M, Bondanelli M, Ambrosio MR, degli Uberti EC (2004) Cerebral aneurysm and acromegaly: a case report. J Endocrinol Invest 27(8):770–773

    PubMed  CAS  Google Scholar 

  7. Curto L, Squadrito S, Almoto B, Longo M, Granata F, Salpietro F, Torre ML, Marini F, Trimarchi F, Cannavo S (2007) MRI finding of simultaneous coexistence of growth hormone-secreting pituitary adenoma with intracranial meningioma and carotid artery aneurysms: report of a case. Pituitary 10(3):299–305

    Article  PubMed  Google Scholar 

  8. Manara R, Maffei P, Citton V, Rizzati S, Bommarito G, Ermani M, Albano I, Della Puppa A, Carollo C, Pavesi G, Scanarini M, Ceccato F, Sicolo N, Mantero F, Scaroni C, Martini C (2011) Increased rate of intracranial saccular aneurysms in acromegaly: an MR angiography study and review of the literature. J Clin Endocrinol Metab 96(5):1292–1300

    Article  PubMed  CAS  Google Scholar 

  9. Yoshimoto Y (2006) A mathematical model of the natural history of intracranial aneurysms: quantification of the benefit of prophylactic treatment. J Neurosurg 104(2):195–200

    Article  PubMed  Google Scholar 

  10. Tanimoto K, Hizuka N, Fukuda I, Takano K, Hanafusa T (2008) The influence of age on the GH-IGF1 axis in patients with acromegaly. Eur J Endocrinol 159(4):375–379

    Article  PubMed  CAS  Google Scholar 

  11. Wardlaw JM, White PM (2000) The detection and management of unruptured intracranial aneurysms. Brain 123(Pt 2):205–221

    Article  PubMed  Google Scholar 

  12. Ellamushi HE, Grieve JP, Jager HR, Kitchen ND (2001) Risk factors for the formation of multiple intracranial aneurysms. J Neurosurg 94(5):728–732

    Article  PubMed  CAS  Google Scholar 

  13. Harrod CG, Batjer HH, Bendok BR (2006) Deficiencies in estrogen-mediated regulation of cerebrovascular homeostasis may contribute to an increased risk of cerebral aneurysm pathogenesis and rupture in menopausal and postmenopausal women. Med Hypotheses 66(4):736–756

    Article  PubMed  CAS  Google Scholar 

  14. Horiuchi T, Tanaka Y, Hongo K (2006) Sex-related differences in patients treated surgically for aneurysmal subarachnoid hemorrhage. Neurol Med Chir (Tokyo) 46(7): 328–332, discussion 332

    Google Scholar 

  15. Horikoshi T, Akiyama I, Yamagata Z, Nukui H (2002) Retrospective analysis of the prevalence of asymptomatic cerebral aneurysm in 4518 patients undergoing magnetic resonance angiography–when does cerebral aneurysm develop? Neurol Med Chir (Tokyo) 42(3): 105–112, discussion 113

    Google Scholar 

  16. Schwab KE, Gailloud P, Wyse G, Tamargo RJ (2008) Limitations of magnetic resonance imaging and magnetic resonance angiography in the diagnosis of intracranial aneurysms. Neurosurgery 63(1): 29–34, discussion 34–25

    Google Scholar 

  17. Kulseng B, Myhre HO (2006) Is insulin growth factor-1 (IGF-1) playing a role for aneurysm formation in patients with pituitary gland tumor? Int Angiol 25(4):433–435

    PubMed  CAS  Google Scholar 

  18. Maffei P, Menegazzo C, Michelotto M, Salmaso R, Martini C, De Carlo E, Carli M, Barban M, Fassina A, Vettor R, Sicolo N (2008) Sudden death due to aortic rupture in acromegaly. Heart Vessels 23(1):71–74

    Article  PubMed  Google Scholar 

  19. Yamamoto T, Kurosaka M, Sugimoto T (2001) A true aneurysm of the femoral artery in acromegaly. Clin Imaging 25(2):126–129

    Article  PubMed  CAS  Google Scholar 

  20. Izgi C, Cevik C, Nugent K (2010) Annuloaortic ectasia and ascending aortic aneurysm as a cardiovascular manifestation of acromegaly. Cardiovasc Intervent Radiol 33(2):438–440

    Google Scholar 

  21. Acqui M, Ferrante L, Matronardi L, d’Addetta R (1988) Alteration of the collagen type III/type I ratio and intracranial saccular aneurysms in GH-secreting hypophyseal adenomas. Ital J Neurol Sci 9(4):365–368

    Article  PubMed  CAS  Google Scholar 

  22. Paisley AN, O’Callaghan CJ, Lewandowski KC, Parkinson C, Roberts ME, Drake WM, Monson JP, Trainer PJ, Randeva HS (2006) Reductions of circulating matrix metalloproteinase 2 and vascular endothelial growth factor levels after treatment with pegvisomant in subjects with acromegaly. J Clin Endocrinol Metab 91(11):4635–4640

    Article  PubMed  CAS  Google Scholar 

  23. Izgi C, Cevik C, Nugent K (2010) Annuloaortic ectasia and ascending aortic aneurysm as a cardiovascular manifestation of acromegaly. Cardiovasc Intervent Radiol 33(2):438–440

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors thank to Ms. Sachiko Yamasaki for her help in collection the data of brain checkup, and also thanks to Mrs. Keiko Takeoka for technical comments based and her excellent work in clinical laboratory.

Ethical standards

This study was approved by the Ethical Committee of Osaka University Hospital (No. 10100).

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Graduate School of Medicine, Osaka University, Osaka, Japan

    Satoru Oshino, Hideyuki Arita, Manabu Kinoshita, Toshiki Yoshimine & Youichi Saitoh

  2. Department of Neurosurgery, Hanwa Memorial Hospital, Osaka, Japan

    Akio Nishino

  3. Department of Neurosurgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

    Tsuyoshi Suzuki

  4. Department of Neurosurgery, Kansai Rosai Hospital, Hyogo, Japan

    Akihiro Tateishi

  5. Department of Neurosurgery, Iseikai Hospital, Osaka, Japan

    Katsumi Matsumoto

  6. Department of Engineering, University of Yamanashi, Yamanashi, Japan

    Toshio Shimokawa

  7. Department of Neuromodulation and Neurosurgery Office for University-Industry Collaboration, Osaka University, 2-1 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan

    Youichi Saitoh

Authors
  1. Satoru Oshino
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  2. Akio Nishino
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  3. Tsuyoshi Suzuki
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  4. Hideyuki Arita
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  5. Akihiro Tateishi
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  6. Katsumi Matsumoto
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  7. Toshio Shimokawa
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  8. Manabu Kinoshita
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  9. Toshiki Yoshimine
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  10. Youichi Saitoh
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Corresponding author

Correspondence to Youichi Saitoh.

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Oshino, S., Nishino, A., Suzuki, T. et al. Prevalence of cerebral aneurysm in patients with acromegaly. Pituitary 16, 195–201 (2013). https://doi.org/10.1007/s11102-012-0404-x

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  • DOI: https://doi.org/10.1007/s11102-012-0404-x

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