BACKGROUND AND PURPOSE: The natural history of small unruptured intracranial aneurysms of the anterior circulation in the European population is unclear. Therefore, the management of unruptured intracranial aneurysms <7 mm in the anterior circulation is controversial. METHODS: Between June 1999 and June 2012, 384 unruptured intracranial aneurysms of the anterior circulation <7 mm in diameter underwent conservative treatment and regular annual follow-up in our institution. Patient- and aneurysm-specific information, as well as information on aneurysm enlargement and rupture, was entered into a prospectively conducted database. RESULTS: The mean follow-up duration was 48.5±37 months. Three aneurysms enlarged during the follow-up period and were treated by surgical clipping. Three aneurysms were ruptured during the follow-up period. The overall annual incidence of subarachnoid hemorrhage was 0.2% during the follow-up. In the multivariate Cox proportional hazard regression analysis, hypertension (P<0.001; hazard ratio, 2.6; 95% confidence interval, 2.1-3.3) and <50 years of age (P=0.04; hazard ratio, 1.3; 95% confidence interval, 1.01-1.7) were significant independent predictors of aneurysm rupture. CONCLUSIONS: The present data indicate that the annual incidence of subarachnoid hemorrhage associated with small anterior circulation unruptured intracranial aneurysms is low in this single-institution prospective cohort study. The natural course varies according to arterial hypertension and patient age.
BACKGROUND AND PURPOSE: The natural history of small unruptured intracranial aneurysms of the anterior circulation in the European population is unclear. Therefore, the management of unruptured intracranial aneurysms <7 mm in the anterior circulation is controversial. METHODS: Between June 1999 and June 2012, 384 unruptured intracranial aneurysms of the anterior circulation <7 mm in diameter underwent conservative treatment and regular annual follow-up in our institution. Patient- and aneurysm-specific information, as well as information on aneurysm enlargement and rupture, was entered into a prospectively conducted database. RESULTS: The mean follow-up duration was 48.5±37 months. Three aneurysms enlarged during the follow-up period and were treated by surgical clipping. Three aneurysms were ruptured during the follow-up period. The overall annual incidence of subarachnoid hemorrhage was 0.2% during the follow-up. In the multivariate Cox proportional hazard regression analysis, hypertension (P<0.001; hazard ratio, 2.6; 95% confidence interval, 2.1-3.3) and <50 years of age (P=0.04; hazard ratio, 1.3; 95% confidence interval, 1.01-1.7) were significant independent predictors of aneurysm rupture. CONCLUSIONS: The present data indicate that the annual incidence of subarachnoid hemorrhage associated with small anterior circulation unruptured intracranial aneurysms is low in this single-institution prospective cohort study. The natural course varies according to arterial hypertension and patient age.
Authors: W Brinjikji; Y-Q Zhu; G Lanzino; H J Cloft; M H Murad; Z Wang; D F Kallmes Journal: AJNR Am J Neuroradiol Date: 2015-11-26 Impact factor: 3.825
Authors: Keng Siang Lee; John J Y Zhang; Andrew Folusho Alalade; Roanna Vine; Giuseppe Lanzino; Nicholas Park; Gareth Roberts; Nihal T Gurusinghe Journal: Neurosurg Rev Date: 2020-10-22 Impact factor: 3.042