Intracranial arteriopathy in tuberous sclerosis complex.
Arterial aneurysms, mostly aortic and intracranial, have been occasionally reported in patients with tuberous sclerosis complex. Brain magnetic resonance imaging reports of 404 patients with definite and 16 patients with either probable or possible tuberous sclerosis complex were revised for intracranial aneurysms. Among these patients, brain images of 220 patients with definite and 16 with probable or possible tuberous sclerosis complex were reviewed. Intracranial aneurysms were reported in 3 of 404 patients with a definite diagnosis (0.74%) (general population: 0.35%), including 2 children. A fourth intracranial aneurysm was found in a patient with probable tuberous sclerosis complex, who did not have tubers or subependymal nodules but had clinical manifestations related to neural crest derivatives, including lymphangioleiomyomatosis and extrarenal angiomyolipomas. The authors hypothesize that neural crest dysfunction can have a major role in intracranial arteriopathy in tuberous sclerosis complex, as smooth muscle cells in the forebrain vessels are of neural crest origin.
Department of Neurology, Massachusetts General Hospital, Boston, MA, USA Department of Pediatric Neurology, Vall d'Hebron Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.
Susana
S
Boronat
Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
Elias A
EA
Shaaya
Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
Maria
M
Auladell
Department of Neurology, Massachusetts General Hospital, Boston, MA, USA ethiele@partners.org.
Elizabeth A
EA
Thiele
Department of Neuroradiology, Massachusetts General Hospital, Boston, MA, USA.
Paul
P
Caruso
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology; D002536:Cerebral Arteries / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D020765:Intracranial Arterial Diseases / Q000209:etiology*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014402:Tuberous Sclerosis / Q000150:complications* / Q000175:diagnosis; D055815:Young Adult
arteriopathy; intracranial aneurysms; neural crest; tuberous sclerosis complex; vascular