Comprehending the risk factors that contribute to the formation of fusiform aneurysms (FA) might provide some insight into treatment and prevention strategies. This case-control study aimed to compare the levels of serum C-reactive protein (CRP), as a biomarker, between patients with fusiform and saccular intracranial aneurysms.
We retrospectively analyzed medical records from 2010 to 2019. Thirty-five patients were identified as having FA: 13 (37.1%) were ruptured, and 22 were unruptured. An age-matched sample of 70 controls (2:1) with saccular aneurysms was obtained from the same records: 36 (51.4%) ruptured and 34 unruptured.
Patients with FA had median CRP values of 0.61mg/dL (IQR=1.5), compared to 0.29mg/dL (IQR=0.42) in controls (P<0.01). Within both the ruptured and the unruptured group, median CRP was higher in patients with FAs compared to controls (P < 0.01). Diabetes, smoking status, hypertension, and gender did not significantly influence CRP levels. Age-adjusted analyses showed that fusiform morphology was independently associated with higher CRP levels for unruptured aneurysms (OR 1.2, 95%CI 1.05-1.43), but not for ruptured aneurysms (OR 1.02, 95%CI 0.99-1.05).
CRP was higher in patients with FAs than controls, and it constituted an independent predictor of fusiform morphology for patients with unruptured aneurysms. Inflammation might be an especially important factor in FA formation and growth, and further studies could use this finding to design new treatment strategies.

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