title: Association of hypothyroidism with unruptured cerebral aneurysms: a case-control study.
abstract: OBJECTIVE Thyroid disorder has been known to affect vascular function and has been associated with aortic aneurysm formation in some cases; however, the connection has not been well studied. The authors hypothesized that hypothyroidism is associated with the formation of cerebral aneurysms. METHODS The authors performed a retrospective case-control study of consecutive patients who had undergone cerebral angiography at an academic, tertiary care medical center in the period from April 2004 through April 2014. Patients with unruptured aneurysms were identified from among those who had undergone 3-vessel catheter angiography. Age-matched controls without cerebral aneurysms on angiography were also identified from the same database. Patients with previous subarachnoid hemorrhage or intracranial hemorrhage were excluded. History of hypothyroidism and other risk factors were recorded. RESULTS Two hundred forty-three patients with unruptured cerebral aneurysms were identified and age matched with 243 controls. Mean aneurysm size was 9.6 ± 0.8 mm. Hypothyroidism was present in 40 patients (16.5%) and 9 matched controls (3.7%; adjusted OR 3.2, 95% CI 1.3-7.8, p = 0.01). Subgroup analysis showed that men with hypothyroidism had higher odds of an unruptured cerebral aneurysm diagnosis than the women with hypothyroidism, with an adjusted OR of 12.7 (95% CI 1.3-121.9) versus an OR of 2.5 (95% CI 1.0-6.4) on multivariate analysis. CONCLUSIONS Hypothyroidism appears to be independently associated with unruptured cerebral aneurysms, with a higher effect seen in men. Given the known pathophysiological associations between hypothyroidism and vascular dysfunction, this finding warrants further exploration.
authors.affiliation: Departments of1Neurology and.
authors.forename: Kunakorn
authors.initials: K
authors.lastname: Atchaneeyasakul
authors.affiliation: Departments of1Neurology and.
authors.forename: Anita
authors.initials: A
authors.lastname: Tipirneni
authors.affiliation: Departments of1Neurology and.
authors.forename: Tony
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Departments of1Neurology and.
authors.forename: Priyank
authors.initials: P
authors.lastname: Khandelwal
authors.affiliation: 2Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Sudheer
authors.initials: S
authors.lastname: Ambekar
authors.affiliation: 2Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Brian
authors.initials: B
authors.lastname: Snelling
authors.affiliation: Departments of1Neurology and.
authors.forename: Sushrut
authors.initials: S
authors.lastname: Dharmadhikari
authors.affiliation: Departments of1Neurology and.
authors.forename: Chuanhui
authors.initials: C
authors.lastname: Dong
authors.affiliation: Departments of1Neurology and.
authors.forename: Luis
authors.initials: L
authors.lastname: Guada
authors.affiliation: Departments of1Neurology and.
authors.forename: Kevin
authors.initials: K
authors.lastname: Ramdas
authors.affiliation: Departments of1Neurology and.
authors.forename: Seemant
authors.initials: S
authors.lastname: Chaturvedi
authors.affiliation: Departments of1Neurology and.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Rundek
authors.affiliation: Departments of1Neurology and.|2Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Dileep R
authors.initials: DR
authors.lastname: Yavagal
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D016022:Case-Control Studies; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications* / Q000453:epidemiology; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012421:Rupture; D012737:Sex Factors
keywords: cerebral aneurysm; cerebral angiography; hypothyroidism; subarachnoid hemorrhage; vascular disorders