MedWire News: Patients with a bicuspid aortic valve (BAV) may be at greatly increased risk for intracranial aneurysms, a case–control study suggests.
BAV is one of the most common forms of congenital heart disease and occurs in up to 2% of adults, say Wouter Schievink (Cedars-Sinai Medical Center, Los Angeles, California, USA) and colleagues.
They note that the arteriopathy of BAV does not appear to be confined to the aorta and spontaneous dissections of the cervical and intracranial arteries have also been reported in affected patients.
To investigate further, the team screened 61 patients with BAV for intracranial aneurysms using magnetic resonance angiography or computed tomography angiography.
Results were then compared with 291 individuals undergoing magnetic resonance angiography for suspected stroke or brain tumors over the same period, who served as a control group.
Intracranial aneurysms were detected in 9.8% of the patients with BAV versus just 1.1% of control participants, a difference that was statistically significant, the researchers report in the journal Neurology.
They add that being female and of advanced age – both risk factors for intracranial aneurysm development – were significantly more common among individuals in the control group than in BAV patients.
There were no significant differences between BAV patients with and without intracranial aneurysms in terms of age, gender, smoking, arterial hypertension, alcohol use, aortic diameter, or frequency of aortic co-arctation.
Schievink et al note that intracranial aneurysms are treatable lesions that, once ruptured, are associated with a high risk for death and disability.
They add: “An abnormality of cells derived from the neural crest (neurocristopathy) could explain the association of BAV with intracranial aneurysms found in our study.”
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By Anita Wilkinson