ESR1 and Dilatation of the cerebral artery: Recently, in an estrogen-deficient aneurysm model, the deficiency of estrogen receptor alpha (ERα) and SIRT1 may contribute to inflammation and tissue damage, promoting the activation of the NLRP3/IL-1b/MMP-9 pathway, thereby increasing the risk of intracranial aneurysm rupture and SAH [89].