title: The role of estrogen on the pathology of cerebral aneurysms.
abstract: Epidemiological studies suggest that postmenopausal estrogen deficiency is responsible for the increased risk of aneurysmal subarachnoid hemorrhage, while menopausal hormone therapy is protective against cerebral aneurysms. These findings indicate the critical role of estrogen in the pathophysiology of cerebral aneurysm.
  
  
  
  Here, we provide a narrative review for understanding the roles of estrogen and estrogen receptors in the pathogenesis of cerebral aneurysms. A specific selective estrogen receptor modulator is a potential drug for cerebral aneurysms, since it may favorably interact with estrogen receptors while avoiding unwanted side effects related to estrogen therapy. Expert Commentary: Future investigations into the role of estrogen on cerebral aneurysm pathophysiology may lead to the development of a novel drug, which interacts with estrogen receptors to modify the pathological mechanism of cerebral aneurysm formation on postmenopausal women.
authors.affiliation: a Department of Neurosurgery , Helsinki University Central Hospital , Helsinki , Finland.|b Department of Neurosurgery , Institute of Biomedical Sciences, Tokushima University Graduate School , Tokushima , Japan.
authors.forename: Hidetsugu
authors.initials: H
authors.lastname: Maekawa
authors.affiliation: a Department of Neurosurgery , Helsinki University Central Hospital , Helsinki , Finland.|c Neuroscience Institute , Virginia Mason Medical Center , Seattle , WA , USA.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Serrone
authors.affiliation: a Department of Neurosurgery , Helsinki University Central Hospital , Helsinki , Finland.|d Department of Neurosurgery , Mitra Keluarga Group Hospital , Jakarta , Indonesia.
authors.forename: Mardjono
authors.initials: M
authors.lastname: Tjahjadi
authors.affiliation: a Department of Neurosurgery , Helsinki University Central Hospital , Helsinki , Finland.
authors.forename: Juha
authors.initials: J
authors.lastname: Hernesniemi
keywords: Cerebral aneurysm; endothelial cell; estrogen; estrogen receptor; extracellular matrix; inflammation; selective estrogen receptor modulator; subarachnoid hemorrhage; vascular remodeling; vascular smooth muscle cell