Abstract
Oral bacteria DNA has been found in intracranial aneurysms (IA) and a high prevalence of periodontitis was reported in IA patients. We investigated whether periodontitis associates with IA formation and aneurysmal subarachnoid hemorrhage (aSAH). First, we compared in a case-control setting the prevalence of periodontal disease in IA patients (42 unruptured IA, 34 ruptured IA) and in age- and gender-matched controls (n = 70) from the same geographical area (Health 2000 Survey, BRIF8901). Next, we investigated whether periodontitis at baseline associated with aSAH in a 13-year follow-up study of 5170 Health 2000 Survey participants. Follow-up data was obtained from national hospital discharge and cause of death registries. Univariate analysis, logistic regression, and Cox-regression were used. Periodontitis (≥ 4mm gingival pocket) and severe periodontitis (≥ 6mm gingival pocket) were found in 92% and 49% of IA patients respectively and associated with IAs (OR 5.3, 95%CI 1.1–25.9, p < 0.000 and OR 6.3, 95%CI 1.3–31.4, p < 0.001, respectively). Gingival bleeding had an even stronger association, especially if detected in 4–6 teeth sextants (OR 34.4, 95%CI 4.2–281.3). Severe periodontitis in ≥ 3 teeth or gingival bleeding in 4–6 teeth sextants at baseline increased the risk of aSAH during follow-up (HR 22.5, 95%CI 3.6–139.5, p = 0.001 and HR 8.3, 95%CI 1.5–46.1, p = 0.015, respectively). Association of periodontitis and gingival bleeding with risk of IA development and aSAH was independent of gender, smoking status, hypertension, or alcohol abuse. Periodontitis and gingival bleeding associate with increased risk for IA formation and eventual aSAH. Further epidemiological and mechanistic studies are indicated.
Highlights
Intracranial aneurysms (IA) are pathological dilatations in cerebral arteries that may rupture causing devastating aneurysmal subarachnoid hemorrhage
IAs are common with a prevalence of 2–3% [1] in the adult population, aneurysmal subarachnoid hemorrhage (aSAH) caused by IA rupture is a relatively rare event [2]
Since prior literature suggests oral infections and especially periodontitis might predispose patients to the formation and progression of IAs, as it does for extracranial aneurysms [13, 14], we investigated whether periodontitis or clinically evident gingival inflammation is an independent risk factor for either IA formation or aSAH
Summary
Intracranial aneurysms (IA) are pathological dilatations in cerebral arteries that may rupture causing devastating aneurysmal subarachnoid hemorrhage (aSAH). IAs are common with a prevalence of 2–3% [1] in the adult population, aSAH caused by IA rupture is a relatively rare event (incidence approximately 10/100,000/year) [2]. Due to the high mortality (40%) and morbidity associated with aSAH, unruptured IAs are frequently treated by endovascular or microsurgical procedures [4]. Both of these current treatment options are, associated with risk of serious complications (5–7%), including death [5, 6]. There is a need for reliable strategies to estimate rupture risk and avoid unnecessary treatments
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
