Unruptured Intracranial Aneurysms

Abstract

It is estimated that approximately 10 to 15 million Americans have intracranial aneurysms. Intracranial aneurysms are classified as either unruptured or ruptured. Advances in knowledge and technology are enhancing diagnosis, management, and outcomes associated with unruptured intracranial aneurysms. Optimal outcomes are achieved when aneurysms are treated before they rupture. If the aneurysm ruptures, the mortality rate ranges from 30% to 60%. A review of evidence regarding aneurysms, including the pathogenesis, risk factors, treatment options, and outcomes, is presented. Treatment options addressed include surgical clipping, endovascular coiling, or watchful waiting. Current evidence supports aggressive treatment for patients with previously ruptured aneurysms, large or symptomatic aneurysms, a family history of aneurysm rupture, a long life expectancy, and aneurysms demonstrating growth. Factors that favor watchful waiting include aneurysms that are small or located in the anterior circulation and in patients with a short life expectancy or comorbid medical conditions. Nurses are in an ideal position to use evidence and outcomes to provide accurate and current information on how to reduce the risks for rupture and evaluate treatment options.

Clinical Evaluation of an Innovative Metal-Artifact-Reduction Algorithm in FD-CT Angiography in Cerebral Aneurysms Treated by Endovascular Coiling or Surgical Clipping

“…In 14 iMAR− datasets, SC grading was (0); and in 2 iMAR− datasets, grading was (6). Findings in iMAR+ datasets showed better agreement with DSA than findings in iMAR− datasets (n correct iMAR+ = 14, n correct iMAR− = 2).…”

“…In 1 iMAR+ dataset, SC grading was (1); in 1 iMAR+ dataset grading was (2); and in 14 iMAR+ datasets, grading was (6).…”

“…Because of a potential re-bleeding in up to 15% of cases in the first few hours after initial rupture with a consequently very poor prognosis [4], prompt occlusion of ruptured IAs is absolutely indicated [5]. In unruptured IAs, treatment (including surgical clipping, endovascular coiling/stenting or watchful waiting) depends on aneurysm size, location, a patient history of previous ruptured aneurysms, family history of ruptured aneurysms, life expectancy, and growth tendencies of the aneurysm [6].…”

“…patient history of previous ruptured aneurysms, family history of ruptured aneurysms, life expectancy, and growth tendencies of the aneurysm [6].…”

Self-Efficacy and Self-Care Behavior in Patients with Unruptured Intracranial Aneurysm after Treatment with Coil Embolization

“…으로 2008년에 비해 2.6배 증가하였고, 파열성 뇌동맥류는 100,000명당 12.6건으로 2008년 이후 20.3% 감소하였으며, 비파열성 뇌동맥류의 코일색전술은 9년에 걸쳐 3.4배 증가 하였다. 2) 디지털 감산 혈관조영술(digital subtraction angiography), 자기공명 혈관조영술, 컴퓨터단층 혈관조영술과 같은 영상 검사와 뇌혈관 검사의 시행이 증가하면서 증상이 없는 뇌동 맥류의 발생 빈도가 증가하고 있고, 1,2) 비파열성 뇌동맥류의 진단, 관리 및 치료 결과가 향상되고 있지만, 뇌동맥류가 파 열되면 사망률은 30-60%로 높고, 3) 신경학적 합병증을 초래 할 수 있는 심각한 질환이다.…”