A model for predicting the growth of unruptured intracranial aneurysms: Beyond fortune telling

Because of the tremendous initial and long-term morbidity and mortality incurred by intracranial aneurysm rupture, preventive treatment of unruptured intracranial aneurysms is an appealing strategy to prevent subarachnoid hemorrhage (SAH). However, intervention with surgical or endovascular therapy has risk for considerable procedural complications, especially for large or posterior circulation aneurysms.1,2 Therefore, determining the indications for treatment is crucial to optimizing the management of unruptured aneurysms. Approximately 10% to 20% of unruptured aneurysms will enlarge over the first 10 years of follow-up, and this proportion increases to nearly 50% at 20 years.3 Growing unruptured aneurysms pose substantially greater risk of rupture compared to those of stable size; one study found that growing unruptured aneurysms had a 12-fold higher rupture risk.4 On the basis of these findings, unruptured aneurysm growth has served as a surrogate indicator of impending rupture and thus as an impetus for intervention.5
Source: Neurology - Category: Neurology Authors: Tags: Stroke prevention, Subarachnoid hemorrhage EDITORIALS Source Type: research