title: Increased rate of intracranial saccular aneurysms in acromegaly: an MR angiography study and review of the literature.
abstract: BACKGROUND
  The concurrence of intracranial aneurysms and acromegaly has been reported and debated previously. Our study in a large number of patients aimed to verify whether acromegaly patients carry a higher risk of harboring intracranial saccular aneurysms and to evaluate the possible relationship using clinical, laboratory, and imaging techniques.
  
  
  METHODS
  A total of 152 of 161 consecutive acromegaly patients (median age, 55.7 yr; 82 females) underwent neuroimaging evaluation of the circle of Willis. Clinical data (disease duration and disease control, hypertension, smoking history, diabetes and dyslipidemia, previous surgery or radiotherapy, previous or current pharmacological therapy), laboratory findings (GH and IGF-I at onset and shortly before examination), and pituitary adenoma imaging features (size and invasiveness of the cavernous sinus) were recorded.
  
  
  RESULTS
  Twenty-six patients (17.3%) harbored 40 newly diagnosed intracranial aneurysms; two other patients had previously undergone aneurysm clipping due to subarachnoid hemorrhage. Ten patients had multiple aneurysms; most of the aneurysms were located in the intracranial tract of the internal carotid artery (67.5%); no aneurysms belonged to the vertebrobasilar circulation. The presence of intracranial aneurysms correlated with GH serum values at disease onset (P < 0.05) and showed a trend to a positive correlation with poor disease control (P = 0.06); no other laboratory, clinical, and radiological findings correlated with the presence of intracranial aneurysms.
  
  
  CONCLUSIONS
  GH serum excess seems to carry an increased risk of developing intracranial aneurysms. A neuroradiological evaluation of the intracranial circulation might therefore be considered in the diagnostic work-up of patients affected with acromegaly.
authors.affiliation: Neuroradiological Unit, University Hospital of Padua, Via Giustiniani 5, 35138 Padua, Italy. enzo.manara@sanita.padova.it
authors.forename: Renzo
authors.initials: R
authors.lastname: Manara
authors.forename: Pietro
authors.initials: P
authors.lastname: Maffei
authors.forename: Valentina
authors.initials: V
authors.lastname: Citton
authors.forename: Silvia
authors.initials: S
authors.lastname: Rizzati
authors.forename: Giulia
authors.initials: G
authors.lastname: Bommarito
authors.forename: Mario
authors.initials: M
authors.lastname: Ermani
authors.forename: Irene
authors.initials: I
authors.lastname: Albano
authors.forename: Alessandro
authors.initials: A
authors.lastname: Della Puppa
authors.forename: Carla
authors.initials: C
authors.lastname: Carollo
authors.forename: Giacomo
authors.initials: G
authors.lastname: Pavesi
authors.forename: Massimo
authors.initials: M
authors.lastname: Scanarini
authors.forename: Filippo
authors.initials: F
authors.lastname: Ceccato
authors.forename: Nicola
authors.initials: N
authors.lastname: Sicolo
authors.forename: Franco
authors.initials: F
authors.lastname: Mantero
authors.forename: Carla
authors.initials: C
authors.lastname: Scaroni
authors.forename: Chiara
authors.initials: C
authors.lastname: Martini
mesh_terms: D000172:Acromegaly / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology; D002941:Circle of Willis / Q000000981:diagnostic imaging; D003131:Combined Modality Therapy; D005260:Female; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000150:complications / Q000473:pathology / Q000601:surgery; D006801:Humans; D002532:Intracranial Aneurysm / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D010902:Pituitary Gland / Q000601:surgery; D011859:Radiography; D012307:Risk Factors; D055815:Young Adult; D015021:Yttrium Radioisotopes / Q000627:therapeutic use
chemical_list: D015021:Yttrium Radioisotopes