Radiation-Induced Aneurysm Formation in Intracranial Vascular Systems

Radiation‐induced aneurysm formation within intracranial vessels represents a rare but serious delayed complication of therapeutic cranial irradiation. Endothelial injury, chronic inflammation and progressive fibrosis of the arterial wall contribute to focal weakening, predisposing to aneurysm development years after initial exposure. Radiation doses delivered during stereotactic radiosurgery or conventional fractionated radiotherapy can damage vasa vasorum and accelerate atherosclerotic change, leading to diverse aneurysm morphologies—including fusiform, saccular and dissecting types. Latency periods vary widely, often extending beyond a decade, and clinical presentations range from incidental imaging findings to life‐threatening subarachnoid haemorrhage or ischaemic symptoms. Recognition of this phenomenon has grown alongside the expanding use of targeted radiotherapy for skull‐base and intracranial neoplasms. Surveillance strategies and timely intervention are essential to mitigate the high morbidity and mortality associated with ruptured lesions, underscoring the need for multidisciplinary collaboration between neuro‐oncologists, neuroradiologists and cerebrovascular surgeons.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Radiation-Induced Aneurysm Formation in Intracranial Vascular Systems publication trend

The graph below shows the total number of articles in radiation-induced aneurysm formation in intracranial vascular systems across all publications each year (not limited to Nature Index journals).

Technical terms

Stereotactic radiosurgery (SRS): A highly precise form of radiotherapy delivering focused, high‐dose radiation to intracranial targets in one or a few sessions.

Fusiform aneurysm: A spindle‐shaped dilatation involving the entire circumference of an arterial segment, often linked to vessel wall weakening rather than focal endothelial defects.

Dissecting aneurysm: A lesion arising from a tear in the arterial intima that allows blood to split the vessel wall layers.

Latency period: The interval between radiation exposure and the clinical or radiological manifestation of an aneurysm.

Endovascular embolisation: A minimally invasive technique that occludes an aneurysm sac or parent vessel using coils or liquid embolic agents.

References

1. Case report: Ruptured internal carotid artery fusiform aneurysm mimicking pituitary apoplexy after stereotactic radiosurgery. Frontiers in Neurology (2023).
2. Intracranial aneurysms formation after radiotherapy for head and neck cancer: a 10-year nationwide follow-up study. BMC Cancer (2019).
3. Unruptured anterior Inferior cerebellar artery aneurysm following stereotactic irradiation for vestibular schwannoma: Case report and literature review. Frontiers in Surgery (2023).