A Review of Size and Location of Ruptured Intracranial Aneurysms

Forget, Thomas R.; Benitez, Ronald P.; Veznedaroglu, Erol; Sharan, Ashwini; Mitchell, William; Silva, Marco; Rosenwasser, Robert H.

doi:10.1097/00006123-200112000-00006

Cited by 263 publications

(207 citation statements)

References 10 publications

Supporting

Mentioning

171

Contrasting

Unclassified

Order By: Relevance

“…Nevertheless, the majority of ruptured and unruptured aneurysms are still < 7 mm, and a substantial percentage of ruptured aneurysms are even < 5 mm. 11,27,28 Thus, aneurysm size and location appear to be insufficient single parameters to guide treatment decisions, but they can at least serve as a guide for higher risk lesions.…”

Section: 40mentioning

confidence: 99%

Unruptured intracranial aneurysms and the assessment of rupture risk based on anatomical and morphological factors: sifting through the sands of data

Lall¹,

Eddleman²,

Bendok³

et al. 2009

FOC

132

View full text Add to dashboard Cite

Aneurysmal subarachnoid hemorrhage continues to have high rates of morbidity and mortality for patients despite optimal medical and surgical management. Due to the fact that aneurysmal rupture can be such a catastrophic event, preventive treatment is desirable for high-risk lesions. Given the variability of the literature evaluating unruptured aneurysms regarding basic patient population, clinical practice, and aneurysm characteristics studied, such as size, location, aspect ratio, relationship to the surrounding vasculature, and the aneurysm hemodynamics, a metaanalysis is nearly impossible to perform. This review will instead focus on the various anatomical and morphological characteristics of aneurysms reported in the literature with an attempt to draw broad inferences and serve to highlight pressing questions for the future in our continued effort to improve clinical management of unruptured intracranial aneurysms.

show abstract

Section: 40mentioning

confidence: 99%

Unruptured intracranial aneurysms and the assessment of rupture risk based on anatomical and morphological factors: sifting through the sands of data

Lall¹,

Eddleman²,

Bendok³

et al. 2009

FOC

132

View full text Add to dashboard Cite

show abstract

“…Some factors, such as hypertension, arteriosclerosis, intrinsic disorders of the vessel wall, contraceptive use, and trauma can predispose to true PCoA aneurysms. Several studies have reported that PCoA and anterior communicating artery aneurysms are more prone to rupture than aneurysms in other parts (2,3,4,5). In the analysis of the available information from the included case reports and case series, 44 of 49 (89.8%) "true" PCoA aneurysms were ruptured, demonstrating that true posterior communicating artery aneurysms are more prone to rupture (6,14).…”

Section: Discussionmentioning

confidence: 97%

Endovascular treatment of ruptured true posterior communicating artery aneurysms

Yang¹,

Su²,

Meng³

2014

Turkish Neurosurgery

View full text Add to dashboard Cite

AIm: Although true posterior communicating artery (PCoA) aneurysms are rare, they are of vital importance. We reviewed 9 patients with this fatal disease, who were treated with endovascular embolization, and discussed the meaning of endovascular embolization for the treatment of true PCoA aneurysms. mATErIAl and mEThOds: From September 2006 to May 2012, 9 patients with digital substraction angiography (DSA) confirmed true PCoA aneurysms were treated with endovascular embolization. Patients were followed-up with a minimal duration of 17 months and assessed by Glasgow Outcome Scale (GOS) score.rEsulTs: All the patients presented with spontaneous subarachnoid hemorrhage from the ruptured aneurysms. The ratio of males to females was 1:2, and the average age of onset was 59.9 (ranging from 52 to 72) years. The preoperative Hunt-Hess grade scores were I to III. All patients had recovered satisfactorily. No permanent neurological deficits were left. CONClusION:Currently, endovascular embolization can be recommended as the top choice for the treatment of most true PCoA aneurysms, due to its advanced technique, especially the application of the stent-assisted coiling technique, combined with its advantage of mininal invasiveness and quick recovery. However, the choice of treatment methods should be based on the clinical and anatomical characteristics of the aneurysm and the skillfulness of the surgeon. BulGulAr: Tüm hastalar rüptüre anevrizmalardan spontan subaraknoid kanamayla geldi. Erkeklerin kadınlara oranı 1:2 şeklindeydi ve ortalama başlangıç yaşı 59,9 (52-72) yıldı. Preoperatif Hunt-Hess ölçeği puanları I ila III şeklindeydi. Tüm hastalar tatminkar şekilde iyileşmişti. Herhangi bir kalıcı nörolojik defisit yoktu. sONuÇ: Şu anda endovasküler embolizasyon, gelişmiş tekniği ve özellikle stent yardımlı sarmal tekniğinin uygulanması ve minimal invazivlik ve hızlı iyileşmeyle kombine avantajı sayesinde çoğu gerçek PCoA anevrizmasının tedavisinde en iyi tercih olarak önerilebilir. Ancak tedavi yöntemleri seçimi anevrizmanın klinik ve anatomik özellikleri ve cerrahın becerileri temelinde yapılmalıdır.

show abstract

“…In other studies, a significant part of ruptured IAs are small [8,9]. Intracranial aneurysm size is a widely used measurement for rupture risk assessment, but it may miss smaller aneurysms that have a higher rupture risk based on some other characteristics lake location or relationship with the parent blood vessel [10].…”

Section: Discussionmentioning

confidence: 99%

Morphometric Features of Ruptured and Unruptured Aneurysms in Surgically Treated Patients with Multiple Intracranial Aneurysms

Georgieva¹,

Krastev²,

Byulbyuleva³

et al. 2017

UCMS

View full text Add to dashboard Cite

OBJECTIVE: The purpose of the present research was to evaluate the morphometric characteristics of ruptured and unruptured aneurysms in series of surgically treated patients with multiple intracranial aneurysms. According to the findings the differences between ruptured and unruptured aneurysms were analyzed in patients with subarachnoid hemorrhage and multiple intracranial aneurysms. METHODS: Sixty eight patients with 174 multiple aneurysms and clinical presentation of aneurismal subarachnoid hemorrhage were treated in two hospitals in Sofia, Bulgaria between 1991 and 2010. The ruptured aneurysm was identified from preoperative studies (head computed tomography, digital subtraction angiography, computed tomography angiography) and it was proved during the surgical procedure. The preoperative angiograms were used to perform measurements of morphometric characteristics of ruptured and unruptured cerebral aneurysms. We used univariable logistic regression analysis to obtain odds ratios. Cochran-Mantel-Haenszel test for dependence was performed to obtain adjusted odds ratio and P value for dependence. RESULTS: In 16 (23.53%) patients, the ruptured aneurysm was not the largest one. The calculated odds ratios with 95% confidence intervals revealed strong association with rupture for the aneurysm size ≥ 7.5 mm, aneurysm location at anterior communicating-anterior cerebral artery complex, irregular aneurysm shape and angle of inclination. The average value of the angle of inclination was 153.06° ± 21.16 for the ruptured aneurysms and 106.78° ± 29.50. After performing a test for dependence and adjustment for aneurysm size and location, size ratio, irregular shape, terminal aneurysm type and aneurysm inclination angle were strongly associated with aneurysm rupture. CONCLUSION: The only independent significant determinant for aneurysm rupture besides aneurysm size and location was aneurysm inclination angle (P < 0.05).

show abstract

A Review of Size and Location of Ruptured Intracranial Aneurysms

Abstract: We argue that the risk of small aneurysms rupturing is not insignificant, especially those of the anterior communicating artery. Our findings indicate that surgery on unruptured aneurysms should not be predicated on aneurysm size alone.

Cited by 263 publications

References 10 publications

Unruptured intracranial aneurysms and the assessment of rupture risk based on anatomical and morphological factors: sifting through the sands of data

Unruptured intracranial aneurysms and the assessment of rupture risk based on anatomical and morphological factors: sifting through the sands of data

Endovascular treatment of ruptured true posterior communicating artery aneurysms

Morphometric Features of Ruptured and Unruptured Aneurysms in Surgically Treated Patients with Multiple Intracranial Aneurysms

Contact Info

Product

Resources

About