Turkish Neurosurgery
Relationship between brain tumors and intracranial aneurysms: a systematic review
Pedro Henrique Mouty Rabello1, Nícollas Nunes Rabelo1, João Paulo Mota Telles2, Eberval Gadelha Figueiredo1
1University of São Paulo School of Medicine, Department of Neurosurgery, São Paulo/São Paulo,
2University of São Paulo School of Medicine, Department of Neurology, São Paulo/São Paulo,
DOI: 10.5137/1019-5149.JTN.43614-23.4

Background: The presence of brain neoplasms associated with intracranial aneurysms (IAs) is uncommon and whether there is a causal relationship between these two pathologies remains unclear. The incidence of this association has increased due to improved detection with the use of sophisticated neuroimaging techniques. It is important to investigate how these two pathologies are related, whether this potential interaction worsens patient prognosis, and how treatment should be planned and conducted. The purpose of this study is to investigate the possible relationship between intracranial aneurysms and brain neoplasms. Method: A comprehensive literature review involving a search of the databases PubMed and Embase to identify relevant articles was conducted in March 2021. The initial search retrieved 451 articles. After deduplication and screening of abstracts, 56 articles were selected. After reading of the full texts, 19 articles were included in the review. Results: There insufficient evidence to support that people with brain neoplasms have a higher incidence rate of IAs. However, the prevalence of IAs appears to be higher in patients with pituitary tumors than in the general population. The key factors affecting prognosis were tumor type in patients with unruptured aneurysms and progression of subarachnoid hemorrhage in individuals with ruptured aneurysms. Treatment should be individualized according to patient age, tumor pathology, location, and aneurysm rupture risk. Conclusion: There is a lack of evidence to affirm that the existence of brain neoplasm plays a role in the formation and rupture of intracranial aneurysms. Additionally, there is insufficient evidence to confirm a greater prevalence of intracranial aneurysms in individuals with brain tumors. The association of these two disorders does not appear to worsen patient outcome. Prognosis depends on tumor pathology for malignant cases and on subarachnoid hemorrhage in patients with ruptured aneurysms.

Corresponding author : Pedro Henrique Mouty Rabello