Association of hypothyroidism with unruptured cerebral aneurysms: a case-control study

[helvella]

Given that we have seen several papers claiming positive effects from T3 on heart, and the brain and in reperfusion, it seems very unsurprising that lack of thyroid hormone might cause vascular problems. This paper jumps from the accepted impact on aortic aneurysms to cerebral.

J Neurosurg. 2017 Feb 17:1-4. doi: 10.3171/2016.10.JNS161953. [Epub ahead of print]

Association of hypothyroidism with unruptured cerebral aneurysms: a case-control study.

Atchaneeyasakul K1, Tipirneni A1, Zhang T1, Khandelwal P1, Ambekar S2, Snelling B2, Dharmadhikari S1, Dong C1, Guada L1, Ramdas K1, Chaturvedi S1, Rundek T1, Yavagal DR1,2.

Author information

1 Departments of 1 Neurology and.

2 Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida.

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.

KEYWORDS:

cerebral aneurysm; cerebral angiography; hypothyroidism; subarachnoid hemorrhage; vascular disorders

PMID: 28298012

DOI: 10.3171/2016.10.JNS161953

ncbi.nlm.nih.gov/pubmed/282...

[TSH110]

Would this be relevant I wonder to an aunt's premature death from a brain hemorrage? Both her sisters and mother had hypothyroidism but it was never diagnosed in her case. Also one of her daughters appears to have narcolepsy and another looks typically hypothyroid.

[helvella Administrator Thyroid UK in reply to TSH110]

I wouldn't know if the term brain haemorrhage would ever be broken down further by mechanism - e.g. aneurysm versus malformation.

May be at the speculative end of the scale, without further detailed evidence, but certainly seems feasible to me.

[TSH110 in reply to helvella]

helvella I'm afraid I have no detailed information other than it was a brain hemmorhage at 48 and the autopsy reavealed abnormally small blood vessels to the back to the brain. That was third hand info so don't know how reliable it is.

[hairyfairy]

Great! something else for me to worry about!