• Fatimah M Albrekkan, Suha Bachir, Mouhammed A Jumaa, Syed Fazal Zaidi, and Azedine Medhkour.
• Division of Neurosurgery, Department of Surgery, University of Toledo Medical Center, Toledo, Ohio, USA; Department of Pediatrics, King Saud University, Riyadh, Saudi Arabia.
• World Neurosurg. 2016 Nov 1; 95: 624.e1-624.e4.

BackgroundMultiple sclerosis (MS) is a common autoimmune and neurodegenerative disease of the central nervous system characterized by inflammatory demyelination, axonal degeneration, and neuronal loss. The exact pathogenesis of MS remains uncertain; however, studies have shown that the development of MS is influenced by genetic and environmental factors. Cerebral aneurysms (CAs) are life-threatening lesions of cerebral vessels characterized by a bulge in the intracranial arterial wall that spontaneously ruptures. It has been hypothesized that patients with MS are at increased risk of developing cerebral aneurysms. This hypothesis can be supported by analyzing the pathogenesis and genetics of the development of MS and CA. To our knowledge, no previous studies have shown an association between MS and CA.Case DescriptionIn this report, we performed middle cerebral artery aneurysm clipping for two patients with MS who were referred to our clinic for CA in the bifurcation of middle cerebral artery that was found incidentally on magnetic resonance imaging. We aim to identify any genetic correlation between MS and CA pathogenesis.ConclusionThis report suggests a possible genetic association between MS and CAs. The strongest evidence of association was found for the TNFRSF1A gene, a proinflammatory gene that is involved in mitogen-activated protein kinase (MAPK) and NF-Kappa B signaling pathways, and has been identified as a candidate gene in the development of MS. MAPKs were also found to be elevated in CAs.Copyright © 2016 Elsevier Inc. All rights reserved.

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