Current Knowledge of and Perspectives about the Pathogenesis of Blood Blister-like Aneurysms of the Internal Carotid Artery: A Review of the Literature

Int J Med Sci. 2021 Mar 3;18(9):2017-2022. doi: 10.7150/ijms.53154. eCollection 2021.

Abstract

Blood blister-like aneurysms (BBAs) are rare and usually appear at nonbranching sites in the supraclinoid portion of the internal carotid artery (ICA). Because it is difficult to obtain histological specimens of the aneurysm wall and because experimental models are challenging to establish, the pathogenesis of BBAs remains uncertain. In this paper, we reviewed the diagnostic, radiological, and pathophysiological characteristics of patients with BBAs. We also summarized the existing evidence and potential mechanisms related to the causes of BBAs. Current evidence indicates that atherosclerosis and dissection are the main prerequisites for the formation of BBAs. Hemodynamics may play a role in the process of BBA formation due to the unique vascular anatomy of the supraclinoid ICA. Further research on histopathology and hemodynamics is warranted in this field.

Keywords: Blood blister-like aneurysms; Internal carotid artery; Intracranial aneurysms.; Pathogenesis.

Publication types

  • Review

MeSH terms

  • Aneurysm, Ruptured / diagnosis
  • Aneurysm, Ruptured / etiology*
  • Aneurysm, Ruptured / pathology
  • Aneurysm, Ruptured / therapy
  • Carotid Artery Diseases / diagnosis
  • Carotid Artery Diseases / etiology*
  • Carotid Artery Diseases / pathology
  • Carotid Artery Diseases / therapy
  • Carotid Artery, Internal / diagnostic imaging
  • Carotid Artery, Internal / pathology*
  • Carotid Artery, Internal / surgery
  • Cerebral Angiography
  • Embolization, Therapeutic
  • Endovascular Procedures / instrumentation
  • Endovascular Procedures / methods
  • Humans
  • Intracranial Aneurysm / diagnosis
  • Intracranial Aneurysm / etiology*
  • Intracranial Aneurysm / pathology
  • Intracranial Aneurysm / therapy
  • Microsurgery / methods
  • Stents
  • Treatment Outcome