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Genetischer Einfluss bei intrakraniellen Aneurysmen

Influence of genetics in intracranial aneurysms

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Zusammenfassung

Hintergrund

Die Prävalenz unrupturierter intrakranieller arterieller Aneurysmen beträgt etwa 3–5 %. Die bei einer Aneurysmaruptur auftretende Subarachnoidalblutung betrifft vor allem Menschen im mittleren Lebensalter und ist mit einer hohen Morbidität und Mortalität vergesellschaftet. Durch den zunehmenden Einsatz bildgebender Verfahren werden viele solcher Gefäßveränderungen heutzutage zufällig entdeckt.

Methode

Die Ätiologie der Aneurysmaentstehung ist heterogen. Neben polygen-multifaktoriellen Erkrankungen, die durch klassische Gefäßrisikofaktoren getriggert werden können, kommen auch monogene Erkrankungen in Betracht. Durch Fortschritte in der Genetik wurde in den letzten Jahren eine Vielzahl von Genen identifiziert, denen eine Rolle in der Aneurysmaentstehung zugesprochen wird.

Schlussfolgerung

Die genetische Basis intrakranieller Aneurysmen weist eine große Heterogenität und Komplexität auf. Zum gegenwärtigen Zeitpunkt stehen außer der Bildgebung keine anerkannten Screening-Methoden zur Verfügung, um Risikopatienten mit asymptomatischen Aneurysmen zu diagnostizieren.

Abstract

Background

The prevalence of unruptured intracranial aneurysms is approximately 3–5%. Subarachnoid hemorrhage caused by rupture of an aneurysm often affects middle-aged people and harbors high morbidity and mortality. The increasing availability of noninvasive imaging techniques over time is accompanied by an increase in the incidental detection of aneurysms.

Methods

The etiology in aneurysm development is heterogeneous. Besides polygenic multifactorial diseases, often triggered by well-established vascular risk factors, monogenic diseases should also be considered. Advances in genetics has helped to identify genes that contribute to the risk of intracranial aneurysm development.

Conclusion

The genetic basis of intracranial aneurysms shows a broad heterogeneity and complexity. Currently, besides imaging there is no reliable diagnostic test to identify patients who are at higher risk for asymptomatic intracranial aneurysms.

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Correspondence to P. Dietrich.

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Für diesen Beitrag wurden von dem Autor keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Dietrich, P. Genetischer Einfluss bei intrakraniellen Aneurysmen. Radiologe 60, 329–333 (2020). https://doi.org/10.1007/s00117-020-00663-9

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