Investigation of the surgically treated and untreated unruptured cerebral aneurysms of the anterior circulation

Effect of Endovascular Treatment on Headache in Elderly Patients with Unruptured Intracranial Aneurysms

“…[10][11][12] Technologic advances have "pushed the envelope" to make the techniques more durable and more applicable to complex types of aneurysms. [13][14][15] Regarding unruptured intracranial aneurysms, many previous investigations [16][17][18][19][20] have focused on the risks for rupture and hemorrhage while the aneurysms were left untreated, as well as the burden of risk that is associated with treatment modalities (surgical vs endovascular treatment) when the aneurysms are to be treated. 21,22 Several studies 6,[23][24][25] have also mentioned the effect of treatment of unruptured intracranial aneurysms on headache.…”

Small Unruptured Intracranial Aneurysm Verification Study

“…In addition, several previous studies have shown that the decision to treat unruptured aneurysms should not be based on aneurysm size alone. 4,16,20,26,27 In view of these data, if the patient is Ͻ50 years of age, is hypertensive, and harbors multiple aneurysms with diameters of Ն4 mm, surgical or endovascular treatment can reasonably be considered for prevention of future aneurysm rupture. Also, based on our current results, if aneurysm enlargement is documented during follow-up, the aneurysm should be treated with a surgical or an endovascular procedure.…”

Risk of Rupture of Unruptured Intracranial Aneurysms in Relation to Patient and Aneurysm Characteristics

“…If rupture of an aneurysm had occurred, the diagnosis SAH was established only by taking history of patients or their relatives in 2 studies, 9,10 by review of medical records in 2, 11,12 by computed tomography, magnetic resonance, surgery, or autopsy in 8, 7,13-19 or not specified in 7 studies. 12,20 -25 The follow-up of the patients was performed by telephone in combination with reviewing medical records in 4 studies, 11,15,25,26 by annual questionnaires in 1, 14 by questionnaires in combination with review of medical records in 2, 16,27 by outpatient clinic visits, telephone calls, and letters in 7, 7,9,10,13,17,18,20 or was not specified in another 5 studies. 12,[21][22][23][24] Eleven studies reported the proportion of patients lost to follow-up; this proportion was 0% in 7 studies, and 0.2%, 5%, 6%, and 35% in the other 4 studies ( Table 1).…”