**Acknowledgements**

We would like thank Dr. Abdul Rashid Mat Mahidin, Dr. Esther Yeow Kar Mun, Dr. Lattish Rao Threemurthy and Dr. Parathythasan a/l Rajaandra for their help.

**41**

**Author details**

Mei-Ling Sharon Tai1

Malaya, Kuala Lumpur, Malaysia

provided the original work is properly cited.

\*, Tsun Haw Toh1

2 SOCSO Tun Razak Rehabilitation Centre, Melaka, Malaysia

\*Address all correspondence to: sharont1990@gmail.com

, Hafez Hussain2

1 Division of Neurology, Department of Medicine, Faculty of Medicine, University

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

and Kuo Ghee Ong2

*Serum Homocysteine and Intracranial Aneurysms DOI: http://dx.doi.org/10.5772/intechopen.88570*

## **Funding source**

This chapter is supported by the University of Malaya UMCares grant RU013-2017C.

*Serum Homocysteine and Intracranial Aneurysms DOI: http://dx.doi.org/10.5772/intechopen.88570*

*New Insight into Cerebrovascular Diseases - An Updated Comprehensive Review*

in the mice with iNOS compared to the mice without iNOS [2, 5].

with arteriovenous malformation (AVM) as well as no aneurysms [14].

prevent the development and progression of intracranial aneurysm [17].

endogenous inhibitor of nitric oxide (NO) and is a good predictor of early cardiovascular diseases and mortality [27–30]. In addition, the availability of NO is a

In an animal study conducted in rodents, the development of intracranial aneurysm was prevented by inhibition of nitric oxide synthase (NOS) [5, 31]. Inducible nitric oxide synthase (iNOS) is expressed in human and rat cerebral aneurysms [2]. In another animal study, the size of intracranial aneurysms is significantly smaller

Aminoguanidine is a relatively selective inhibitor of iNOS [2]. Aminoguanidine reduces the number of the aneurysms in rats [2]. In the study by Sadamasa et al., iNOS possibly has management potential in the prevention of the progression of cerebral aneurysms, though it is not necessary for the initiation of cerebral aneu-

However, in another study, there was no association between homocysteine and intracranial aneurysms. Notably, this study was conducted comparing a case group (patients with intracranial aneurysms) with a control group consisting of patients

Raised serum homocysteine can be properly managed with dietary changes [17]. An increase in serum homocysteine can be treated by folic acid, vitamin B12 and vitamin B6 supplements [13, 15]. Folic acid and vitamin B12 supplements can

In conclusion, we believe that there is association between raised serum homocysteine and development or progression of intracranial aneurysms. In the future, more case-control research studies can be conducted to compare the patients with intracranial aneurysms and patients without intracranial aneu-

We would like thank Dr. Abdul Rashid Mat Mahidin, Dr. Esther Yeow Kar Mun, Dr. Lattish Rao Threemurthy and Dr. Parathythasan a/l Rajaandra for their help.

This chapter is supported by the University of Malaya UMCares grant

major requirement for the development of intracranial aneurysms [5, 31].

**40**

rysm [2].

**5. Management**

**6. Conclusion**

rysms and AVM.

**Funding source**

RU013-2017C.

**Acknowledgements**
