Fréneau Milène, Baron-Menguy Céline, Vion Anne-Clémence, Loirand Gervaise
Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, France.
Front Cardiovasc Med. 2022 Feb 10;9:815668. doi: 10.3389/fcvm.2022.815668. eCollection 2022.
Intracranial aneurysm (IA) is a frequent and generally asymptomatic cerebrovascular abnormality characterized as a localized dilation and wall thinning of intracranial arteries that preferentially arises at the arterial bifurcations of the circle of Willis. The devastating complication of IA is its rupture, which results in subarachnoid hemorrhage that can lead to severe disability and death. IA affects about 3% of the general population with an average age for detection of rupture around 50 years. IAs, whether ruptured or unruptured, are more common in women than in men by about 60% overall, and more especially after the menopause where the risk is double-compared to men. Although these data support a protective role of estrogen, differences in the location and number of IAs observed in women and men under the age of 50 suggest that other underlying mechanisms participate to the greater IA prevalence in women. The aim of this review is to provide a comprehensive overview of the current data from both clinical and basic research and a synthesis of the proposed mechanisms that may explain why women are more prone to develop IA.
颅内动脉瘤（IA）是一种常见且通常无症状的脑血管异常，其特征为颅内动脉局部扩张和管壁变薄，好发于 Willis 环的动脉分叉处。IA 的毁灭性并发症是其破裂，这会导致蛛网膜下腔出血，进而可能导致严重残疾和死亡。IA 在普通人群中的发病率约为 3%，破裂的平均检测年龄约为 50 岁。IA 无论破裂与否，总体上在女性中比在男性中更为常见，约多 60%，尤其是在绝经后，女性患病风险是男性的两倍。尽管这些数据支持雌激素的保护作用，但 50 岁以下女性和男性 IA 在位置和数量上的差异表明，其他潜在机制也促使女性中 IA 的患病率更高。本综述的目的是全面概述来自临床和基础研究的当前数据，并综合阐述可能解释为何女性更容易发生 IA 的机制。
