TY - JOUR
T1 - Unruptured intracranial aneurysms
T2 - Epidemiology, natural history, management options, and familial screening
AU - Brown, Robert D.
AU - Broderick, Joseph P.
N1 - Funding Information:
RDBJr is principal investigator of the National Institutes of Health (NIH)-funded grant entitled “International Study of Unruptured Intracranial Aneurysms”. JPB is principal investigator of the National Institutes of Neurologic Diseases and Stroke (NINDS)-funded grant entitled “Familial Intracranial Aneurysm study”, which is directly related to the content of this Review. He is also the principal investigator of the NINDS-funded IMS III trial, the NINDS-funded University of Cincinnati SPOTRIAS Center, the NINDS funded T-32 Cerebrovascular Fellowship Training Program for Cerebrovascular Disease, and the National Coordinating Center for the NINDS-funded NIH Stroke Net. JPB is co-investigator of the NINDS-funded Genetic and Environmental Risk Factors for Hemorrhagic Stroke trial, the NINDS-funded study entitled “Comparison of hemorrhagic and ischemic strokes among blacks and whites”, and the NINDS-funded IRIS trial.
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2014/4
Y1 - 2014/4
N2 - Intracranial saccular or berry aneurysms are common, occurring in about 1-2% of the population. Unruptured intracranial aneurysms are increasingly being detected as cross-sectional imaging techniques are used more frequently in clinical practice. Once an unruptured intracranial aneurysm is detected, decisions regarding optimum management are made on the basis of careful comparison of the short-term and long-term risks of aneurysmal rupture with the risk associated with the intervention, whether that be surgical clipping or endovascular management. Several factors need to be carefully considered, including aneurysm size and location, the patient's family history and medical history, and the availability of an interventional option that has an acceptable risk. The patient's knowledge that they have an unruptured intracranial aneurysm can lead to substantial stress and anxiety, and their perspective regarding treatment, after hearing an unbiased appraisal of the rupture risks and the risk of interventional treatment, is of the utmost importance. Controversy remains regarding optimum management, and thorough assessments of the risks and benefits of contemporary management options, specific to aneurysm size, location, and many other aneurysm and patient factors, are needed.
AB - Intracranial saccular or berry aneurysms are common, occurring in about 1-2% of the population. Unruptured intracranial aneurysms are increasingly being detected as cross-sectional imaging techniques are used more frequently in clinical practice. Once an unruptured intracranial aneurysm is detected, decisions regarding optimum management are made on the basis of careful comparison of the short-term and long-term risks of aneurysmal rupture with the risk associated with the intervention, whether that be surgical clipping or endovascular management. Several factors need to be carefully considered, including aneurysm size and location, the patient's family history and medical history, and the availability of an interventional option that has an acceptable risk. The patient's knowledge that they have an unruptured intracranial aneurysm can lead to substantial stress and anxiety, and their perspective regarding treatment, after hearing an unbiased appraisal of the rupture risks and the risk of interventional treatment, is of the utmost importance. Controversy remains regarding optimum management, and thorough assessments of the risks and benefits of contemporary management options, specific to aneurysm size, location, and many other aneurysm and patient factors, are needed.
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U2 - 10.1016/S1474-4422(14)70015-8
DO - 10.1016/S1474-4422(14)70015-8
M3 - Review article
C2 - 24646873
AN - SCOPUS:84896085210
VL - 13
SP - 393
EP - 404
JO - The Lancet Neurology
JF - The Lancet Neurology
SN - 1474-4422
IS - 4
ER -