Research Uncovers Possible Biomarkers of Cerebral Aneurysm

Dr. Stephen J. Marks serves as a vascular neurologist at Neurology Associates of Westchester, where he treats a number of cerebrovascular conditions. Dr. Stephen J. Marks also leads as co-chief of the Cerebrovascular Disease Section at Westchester Medical Center, where he is also the attending neurologist and directs the Cerebrovascular Program and Stroke Center.

In the summer of 2018, the journal Current Neurovascular Research published findings of gene expression differences that may correlate to the development of cerebral aneurysm. Each year, approximately 30,000 individuals in the US experience a ruptured aneurysm, while up to 6 percent may be living with an unruptured cerebral aneurysm.

Researchers believe that screening for these events may one day be possible thanks to the discovery of nine genes that show association with aneurysm risk. The research team identified these genes by manipulating the vessel flow load in the brains of rodent subjects. Some of these subjects were bred to be predisposed to aneurysm, while others were bred resistant to the condition.

Review of the rats' genetic makeup showed that 24 genes were expressed differently when both groups of rats were in an absence of flow loading, or resting state. Flow-loading revealed nine genes that had a strong flow-induced expression related to blood flow, with substantial differences between the aneurysm-prone and aneurysm-resistant rats.

Researchers believe that these genes play a significant part in the brain's ability or inability to restore healthy levels of stress in the arterial walls of the brain following vessel flow load. This discovery may eventually lead to biomarker tests that could identify cerebral aneurysm risk at a stage early enough to halt or reverse aneurysm development, thus reducing the risk of a clinical event.

New Drug Combination May Reduce the Chance of Stroke

A vascular neurologist with Neurology Associates of Westchester, Dr. Stephen J. Marks has focused much of his career on advancing stroke care. Dr. Stephen J. Marks currently directs the Stroke Center and Neurovascular Program at Westchester Medical Center and has contributed to several stroke treatment research initiatives.

Although a major stroke can cause significant and lasting damage, a minor stroke or transient ischemic attack (TIA) is often a less serious medical event. However, minor strokes and TIAs put patients at greater risk of experiencing a major stroke in the future. Many patients receive prescriptions for anticoagulants to lower the chance of major stroke and prevent the reoccurrence of blockages that obstruct blood flow to the brain.

A research team at The University of Texas at Austin found that adding aspirin to this regimen may further reduce a patient's risk of major stroke. The recommendation follows an analysis of data involving nearly 5,000 adult patients across 10 countries who had experienced a minor stroke or TIA. The team noticed that the patients who took aspirin alongside the anticoagulant clopidogrel had a 25 percent lower risk of heart attack, stroke, or clot-related fatality within three months of the primary event.

The researchers discovered that this regimen would increase the risk of bleeding in five out of every 1,000 patients. Patients in this pool could also expect 15 fewer major strokes and other ischemic events. Due to the potential decrease in stroke occurrence and the fact that none of the bleeding events were fatal and most were preventable or treatable, the team concluded that the treatment’s benefits outweigh the risks.