20Jan 2017

A UNIQUE CO-RELATION: POSTMENOPAUSAL ESTROGEN DEFICIENCY AND ANEURYSMAL SUBARACHNOID HEMORRHAGE.

  • Assistant Professor, S. S. Institute of Medical Sciences and Research Centre,Davangere, Karnataka, India.
  • Consultant Neurosurgeon,Dhanush Hospital and Research Centre, Bagalkot, Karnataka, India.
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Background: Rupture of aneurysms often present as subarachnoid haemorrhage (SAH). It is one of the most severe form of stroke especially in female population. Estrogen has a potential influence on the vascular pathophysiology. Several reports have come up with the hypothesis of establishing the role of estrogen on SAH. Hence, revisiting the hypothesis of the possible relationship of estrogen with SAH is utmost necessary to find a rationale therapeutics based on understanding of pathophysiology. Conclusion: Estrogen deficiency has significant impact on SAH. A practical approachbased on pathophysiology is vital in preventing this dreaded complication in peri-menopausal women harbouring unruptured aneurysms.

  1. van Gijn, R. S. Kerr, and G. J. Rinkel, “Subarachnoid haemorrhage,” The Lancet, vol. 369, no. 9558, pp. 306–318, 2007. View at Publisher · View at Google Scholar · View at Scopus
  2. C. Torner, “Epidemiology of subarachnoid hemorrhage,” Seminars in Neurology, vol. 4, no. 03, pp. 354–369, 1984. View at Publisher · View at Google Scholar
  3. Ayala, J. B. Croft, K. J. Greenlund et al., “Sex differences in US mortality rates for stroke and stroke subtypes by race/ethnicity and age, 1995–1998,” Stroke, vol. 33, no. 5, pp. 1197–1201, 2002. View at Publisher · View at Google Scholar · View at Scopus
  4. R. Ostergaard and E. Hog, “Incidence of multiple intracranial aneurysms. Influence of arterial hypertension and gender,” Journal of Neurosurgery, vol. 63, no. 1, pp. 49–55, 1985. View at Publisher · View at Google Scholar · View at Scopus
  5. Juvela, K. Poussa, and M. Porras, “Factors affecting formation and growth of intracranial aneurysms: a long-term follow-up study,” Stroke, vol. 32, no. 2, pp. 485–491, 2001. View at Publisher · View at Google Scholar · View at Scopus
  6. -H. Li, S.-W. Chen, Y.-D. Li et al., “Prevalence of unruptured cerebral aneurysms in Chinese adults aged 35 to 75 years: a cross-sectional study,” Annals of Internal Medicine, vol. 159, no. 8, pp. 514–521, 2013. View at Publisher · View at Google Scholar · View at Scopus
  7. Harada, K. Fukuyama, T. Shirouzu et al., “Prevalence of unruptured intracranial aneurysms in healthy asymptomatic Japanese adults: differences in gender and age,” ActaNeurochirurgica, vol. 155, no. 11, pp. 2037–2043, 2013. View at Publisher · View at Google Scholar · View at Scopus
  8. Zhao, L. Zhang, X. Zhang, Z. Li, L. Tian, and Y.-X. J. Wang, “An analysis of 1256 cases of sporadic ruptured cerebral aneurysm in a single Chinese institution,” PLoS ONE, vol. 9, no. 1, Article ID e85668, 2014. View at Publisher · View at Google Scholar · View at Scopus
  9. K. de Rooij, F. H. H. Linn, J. A. Van Der Plas, A. Algra, and G. J. E. Rinkel, “Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends,” Journal of Neurology, Neurosurgery and Psychiatry, vol. 78, no. 12, pp. 1365–1372, 2007. View at Publisher · View at Google Scholar · View at Scopus
  10. Ding, V. Toll, B. Ouyang, and M. Chen, “Younger age of menopause in women with cerebral aneurysms,” Journal of NeuroInterventional Surgery, vol. 5, no. 4, pp. 327–331, 2013. View at Publisher · View at Google Scholar · View at Scopus
  11. H. H. Linn, G. J. E. Rinkel, A. Algra, and J. Van Gijn, “Incidence of subarachnoid hemorrhage: role of region, year, and rate of computed tomography: a meta-analysis,” Stroke, vol. 27, no. 4, pp. 625–629, 1996. View at Publisher · View at Google Scholar · View at Scopus
  12. H. Young, S. K. Karri, and C. S. Ogilvy, “Exploring the use of estrogen& progesterone replacement therapy in subarachnoid hemorrhage,” Current Drug Safety, vol. 7, no. 3, pp. 202–206, 2012. View at Publisher · View at Google Scholar · View at Scopus
  13. T. Longstreth Jr., L. M. Nelson, T. D. Koepsell, and G. Van Belle, “Subarachnoid hemorrhage and hormonal factors in women. A population-based case-control study,” Annals of Internal Medicine, vol. 121, no. 3, pp. 168–173, 1994. View at Publisher · View at Google Scholar · View at Scopus
  14. Okamoto, R. Horisawa, T. Kawamura et al., “Menstrual and reproductive factors for subarachnoid hemorrhage risk in women: a case-control study in Nagoya, Japan,” Stroke, vol. 32, no. 12, pp. 2841–2844, 2001. View at Publisher · View at Google Scholar · View at Scopus
  15. Stober, S. Sen, T. Anstätt, G. Freier, and K. Schimrigk, “Direct evidence of hypertension and the possible role of post-menopause oestrogen deficiency in the pathogenesis of berry aneurysms,” Journal of Neurology, vol. 232, no. 2, pp. 67–72, 1985. View at Publisher · View at Google Scholar · View at Scopus
  16. Brincat, C. F. Moniz, J. W. W. Studd, A. J. Darby, A. Magos, and D. Cooper, “Sex hormones and skin collagen content in postmenopausal women,” British Medical Journal, vol. 287, no. 6402, pp. 1337–1338, 1983. View at Publisher · View at Google Scholar · View at Scopus
  17. L. Bolognia, I. M. Braverman, M. E. Rousseau, and P. M. Sarrel, “Skin changes in menopause,” Maturitas, vol. 11, no. 4, pp. 295–304, 1989. View at Publisher · View at Google Scholar · View at Scopus
  18. A. Baron, C. La Vecchia, and F. Levi, “The antiestrogenic effect of cigarette smoking in women,” American Journal of Obstetrics and Gynecology, vol. 162, no. 2, pp. 502–514, 1990. View at Publisher · View at Google Scholar · View at Scopus
  19. Horiuchi, Y. Tanaka, and K. Hongo, “Sex-related differences in patients treated surgically for aneurysmal subarachnoid hemorrhage,” Neurologia Medico-Chirurgica, vol. 46, no. 7, pp. 328–332, 2006. View at Publisher · View at Google Scholar · View at Scopus
  20. Igase, I. Matsubara, M. Igase, H. Miyazaki, and K. Sadamoto, “Initial experience in evaluating the prevalence of unruptured intracranial aneurysms detected on 3-tesla MRI,” Cerebrovascular Diseases, vol. 33, no. 4, pp. 348–353, 2012. View at Publisher · View at Google Scholar · View at Scopus
  21. H. M. Vlak, A. Algra, R. Brandenburg, and G. J. E. Rinkel, “Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis,” The Lancet Neurology, vol. 10, no. 7, pp. 626–636, 2011. View at Publisher · View at Google Scholar · View at Scopus
  22. Aarhus, C. A. Helland, and K. Wester, “Differences in anatomical distribution, gender, and sidedness between ruptured and unruptured intracranial aneurysms in a defined patient population,” ActaNeurochirurgica, vol. 151, no. 12, pp. 1569–1574, 2009. View at Publisher · View at Google Scholar · View at Scopus
  23. Inagawa, “Site of ruptured intracranial saccular aneurysms in patients in Izumo City, Japan,” Cerebrovascular Diseases, vol. 30, no. 1, pp. 72–84, 2010. View at Publisher · View at Google Scholar · View at Scopus
  24. L. Kongable, G. Lanzino, T. P. Germanson et al., “Gender-related differences in aneurysmal subarachnoid hemorrhage,” Journal of Neurosurgery, vol. 84, no. 1, pp. 43–48, 1996. View at Publisher · View at Google Scholar · View at Scopus
  25. W. Vernooij, M. A. Ikram, H. L. Tanghe et al., “Incidental findings on brain MRI in the general population,” The New England Journal of Medicine, vol. 357, no. 18, pp. 1821–1828, 2007. View at Publisher · View at Google Scholar · View at Scopus
  26. Chen, B. Ouyang, L. Goldstein-Smith, and L. Feldman, “Oral contraceptive and hormone replacement therapy in women with cerebral aneurysms,” Journal of NeuroInterventional Surgery, vol. 3, no. 2, pp. 163–166, 2011. View at Publisher · View at Google Scholar · View at Scopus
  27. Mizutani, Y. Miki, H. Kojima, and H. Suzuki, “Proposed classification of nonatherosclerotic cerebral fusiform and dissecting aneurysms,” Neurosurgery, vol. 45, no. 2, pp. 253–260, 1999. View at Publisher · View at Google Scholar · View at Scopus
  28. H. Sacho, G. Saliou, A. Kostynskyy, et al., “Natural history and outcome after treatment of unrupturedintradural fusiform aneurysms,” Stroke, vol. 45, no. 11, pp. 3251–3256, 2014. View at Publisher · View at Google Scholar · View at Scopus
  29. C. Serrone, Y. M. Gozal, A. W. Grossman et al., “Vertebrobasilar fusiform aneurysms,” Neurosurgery Clinics of North America, vol. 25, no. 3, pp. 471–484, 2014. View at Publisher · View at Google Scholar · View at Scopus
  30. A. Holzapfel, T. C. Gasser, and R. W. Ogden, “A new constitutive framework for arterial wall mechanics and a comparative study of material models,” Journal of Elasticity, vol. 61, no. 1–3, pp. 1–48, 2000. View at Publisher · View at Google Scholar · View at Scopus
  31. Eriksson, M. Kroon, and G. A. Holzapfel, “Influence of medial collagen organization and axial in situ stretch on saccular cerebral aneurysm growth,” Journal of Biomechanical Engineering, vol. 131, no. 10, Article ID 101010, 2009. View at Publisher · View at Google Scholar · View at Scopus
  32. Kondo, N. Hashimoto, H. Kikuchi, F. Hazama, I. Nagata, and H. Kataoka, “Apoptosis of medial smooth muscle cells in the development of saccular cerebral aneurysms in rats,” Stroke, vol. 29, no. 1, pp. 181–188, 1998. View at Publisher · View at Google Scholar · View at Scopus
  33. Handa, N. Hashimoto, I. Nagata, and F. Hazama, “Saccular cerebral aneurysms in rats: a newly developed animal model of the disease,” Stroke, vol. 14, no. 6, pp. 857–866, 1983. View at Publisher · View at Google Scholar · View at Scopus
  34. D. Robinson, H. L. Judd, P. E. Young, O. W. Jones, and S. S. Yen, “Amniotic fluid androgens and estrogens in midgestation,” Journal of Clinical Endocrinology and Metabolism, vol. 45, no. 4, pp. 755–761, 1977. View at Publisher · View at Google Scholar · View at Scopus
  35. Lind, E. C. Cameron, W. M. Hunter et al., “A prospective, controlled trial of six forms of hormone replacement therapy given to postmenopausal women,” British Journal of Obstetrics and Gynaecology, vol. 86, supplement 3, pp. 1–29, 1979. View at Google Scholar · View at Scopus
  36. Calleja-Agius and M. Brincat, “The effect of menopause on the skin and other connective tissues,” Gynecological Endocrinology, vol. 28, no. 4, pp. 273–277, 2012. View at Publisher · View at Google Scholar · View at Scopus
  37. M. Baron, R. Galea, and M. Brincat, “Carotid artery wall changes in estrogen- treated and -untreated postmenopausal women,” Obstetrics and Gynecology, vol. 91, no. 6, pp. 982–986, 1998. View at Publisher · View at Google Scholar · View at Scopus
  38. M. Kadasi, W. C. Dent, and A. M. Malek, “Cerebral aneurysm wall thickness analysis using intraoperative microscopy: effect of size and gender on thin translucent regions,” Journal of NeuroInterventional Surgery, vol. 5, no. 3, pp. 201–206, 2013. View at Publisher · View at Google Scholar · View at Scopus
  39. A. Khalil, “Estrogen, vascular estrogen receptor and hormone therapy in postmenopausal vascular disease,” Biochemical Pharmacology, vol. 86, no. 12, pp. 1627–1642, 2013. View at Publisher · View at Google Scholar · View at Scopus
  40. J. Gruber, W. Tschugguel, C. Schneeberger, and J. C. Huber, “Production and actions of estrogens,” The New England Journal of Medicine, vol. 346, no. 5, pp. 340–352, 2002. View at Publisher · View at Google Scholar · View at Scopus
  41. Stirone, S. P. Duckles, and D. N. Krause, “Multiple forms of estrogen receptor-? in cerebral blood vessels: regulation by estrogen,” The American Journal of Physiology—Endocrinology and Metabolism, vol. 284, no. 1, pp. E184–E192, 2003. View at Publisher · View at Google Scholar · View at Scopus
  42. H. Kim and J. R. Bender, “Membrane-initiated actions of estrogen on the endothelium,” Molecular and Cellular Endocrinology, vol. 308, no. 1-2, pp. 3–8, 2009. View at Publisher · View at Google Scholar · View at Scopus
  43. Kalesnykas, U. Roschier, J. Puoliväli, J. Wang, and R. Miettinen, “The effect of aging on the subcellular distribution of estrogen receptor-alpha in the cholinergic neurons of transgenic and wild-type mice,” European Journal of Neuroscience, vol. 21, no. 5, pp. 1437–1442, 2005. View at Publisher · View at Google Scholar · View at Scopus
  44. M. Miller and S. P. Duckles, “Vascular actions of estrogens: functional implications,” Pharmacological Reviews, vol. 60, no. 2, pp. 210–241, 2008. View at Publisher · View at Google Scholar · View at Scopus
  45. M. Revankar, D. F. Cimino, L. A. Sklar, J. B. Arterburn, and E. R. Prossnitz, “A transmembrane intracellular estrogen receptor mediates rapid cell signaling,” Science, vol. 307, no. 5715, pp. 1625–1630, 2005. View at Publisher · View at Google Scholar · View at Scopus
  46. Tada, H. Makino, H. Furukawa et al., “Roles of estrogen in the formation of intracranial aneurysms in ovariectomized female mice,” Neurosurgery, vol. 75, no. 6, pp. 690–695, 2014. View at Publisher · View at Google Scholar · View at Scopus
  47. Tada, K. Wada, K. Shimada et al., “Estrogen protects against intracranial aneurysm rupture in ovariectomized mice,” Hypertension, vol. 63, no. 6, pp. 1339–1344, 2014. View at Publisher · View at Google Scholar · View at Scopus
  48. Lin, C. Steenbergen, E. Murphy, and J. Sun, “Estrogen receptor-beta activation results in S-nitrosylation of proteins involved in cardioprotection,” Circulation, vol. 120, no. 3, pp. 245–254, 2009. View at Publisher · View at Google Scholar · View at Scopus
  49. Naftolin, H. P. G. Schneider, and D. W. Sturdee, “Guidelines for hormone treatment of women in the menopausal transition and beyond,” Climacteric, vol. 7, no. 4, pp. 333–337, 2004. View at Publisher · View at Google Scholar · View at Scopus
  50. E. Mendelsohn and R. H. Karas, “HRT and the young at heart,” The New England Journal of Medicine, vol. 356, no. 25, pp. 2639–2641, 2007. View at Publisher · View at Google Scholar · View at Scopus
  51. A. Schreihofer and Y. Ma, “Estrogen receptors and ischemic neuroprotection: who, what, where, and when?” Brain Research, vol. 13, no. 1514, pp. 107–122, 2013. View at Publisher · View at Google Scholar · View at Scopus.

[Malavika J. C. MS, DNBOBG and Vijaykumar S. Shabadi M.Ch Neurosurgery. (2017); A UNIQUE CO-RELATION: POSTMENOPAUSAL ESTROGEN DEFICIENCY AND ANEURYSMAL SUBARACHNOID HEMORRHAGE. Int. J. of Adv. Res. 5 (Jan). 660-665] (ISSN 2320-5407). www.journalijar.com

DR VIJAYKUMAR S. SHABADI
CONSULTANT NEUROSURGEON, DHANUSH HOPSITAL AND RESEARCH CENTER, BAGALKOT 587101

DOI:

Article DOI: 10.21474/IJAR01/2795      
DOI URL: http://dx.doi.org/10.21474/IJAR01/2795

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