Evidence map›Paper›PMID 40084704›Full record

ReviewStroke2025

Genetic Insights Into Hemorrhagic Stroke and Vascular Malformations: Pathogenesis and Emerging Therapeutic Strategies.

Pazhanichamy Kalailingam, Kristiina Rannikmae, Moran Hausman-Kedem, Patricia L Musolino, Ynte M Ruigrok

Abstract readReview
In one paragraph

Review in Stroke, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. iScience · 2026
    Article
  3. Article
  4. Recent advances in biomarkers for cardiac fibrosis.Frontiers in cardiovascular medicine · 2026
    Review
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Pazhanichamy KalailingamDepartment of Neurology (P.K., P.L.M.), Massachusetts General Hospital, Boston.
Kristiina RannikmaeCentre for Medical Informatics, Usher Institute, University of Edinburgh, United Kingdom (K.R.).ORCID 0000-0002-2384-7568
Moran Hausman-KedemPediatric Neurology Institute, Tel Aviv Medical Center, Tel Aviv, affiliated to the Faculty of Medicine, Tel Aviv University, Israel (M.H.-K.).ORCID 0000-0001-5315-3738
Patricia L Musolino *Department of Neurology (P.K., P.L.M.), Massachusetts General Hospital, Boston.
Ynte M Ruigrok *Department of Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, the Netherlands (Y.M.R.).ORCID 0000-0002-5396-2989

Funding

Modeling and Therapeutic Approaches for Genetic VasculopathiesR01NS125353 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI MARK E LINDSAY, Patricia L Musolino · 2022 to 2026
$3.5M
Gene therapy for disorders of the extracellular matrixRF1NS128217 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GOULD, DOUGLAS, MUSOLINO, PATRICIA L · 2023 to 2023
$2.5M
NINDS NIH HHS R01 NS125353NINDS NIH HHS RF1 NS128217
6 · The paper itself

Abstract

Brain arteriovenous malformations (AVMs), cerebral cavernous malformations (CCMs), and intracranial aneurysms are major causes of hemorrhagic stroke, yet noninvasive therapies to prevent growth or rupture are lacking. Understanding the genetic basis of these malformations is critical for uncovering underlying mechanisms, developing targeted prevention strategies, and identifying novel therapeutic targets. This review highlights the causal genes and signaling pathways in AVMs, CCMs, and intracranial aneurysms, noting both their commonalities and differences. For AVMs, somatic mutations in the RAS (rat sarcoma virus)/MAPK (mitogen-activated protein kinase) and MAPK/ERK (extracellular signal-regulated kinase) pathway are key, particularly in sporadic cases, whereas hereditary conditions like hereditary hemorrhagic telangiectasia and capillary malformation-AVM involve the TGF-β (transforming growth factor β), Ephrin receptor, and angiopoietin-VEGF (vascular endothelial growth factor) signaling pathways. In CCMs, pathways affecting endothelial junctions and vascular stability, such as the ROCK (RhoA/Rho-associated coiled-coil containing kinases) pathway, play a central role. Although the genetic drivers of intracranial aneurysms are more diverse and less clearly linked to specific pathways, there is some overlap with genes in the TGF-β and endothelial function pathways seen in AVMs and CCMs. Emerging therapies for AVMs and CCMs include MAPK/ERK inhibitors, anti-VEGF treatments, and RhoA/ROCK inhibitors, showing potential in preclinical models. Due to the genetic overlap, these advancements may also offer future therapeutic strategies for intracranial aneurysms. As personalized medicine progresses, the development of reliable biomarkers, such as the candidate biomarker VEGF for AVMs and CCMs, will be crucial for guiding treatment decisions. In conclusion, ongoing research into genetic pathways holds promise for novel therapeutic targets that could transform the management of vascular malformations and reduce the risk of hemorrhagic stroke.

Indexed as

Hemangioma, Cavernous, Central Nervous SystemHemorrhagic StrokeIntracranial AneurysmIntracranial Arteriovenous MalformationsBiomarkersHumansSignal TransductionBiomarkersgeneticshemorrhagic strokeintracranial aneurysmstelangiectasia, hereditary hemorrhagicvascular malformations

Identifiers

PMID40084704
PMCPMC12037314

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.