The detection of an unruptured intracranial aneurysm poses a dilemma for the patient and the physician: an aneurysm rupture is a catastrophic event, but preventive repair is not without risks. The recently updated AHA/ASA guidelines provide some foundation for decision-making by summarizing the available evidence, but several clinically relevant questions remain uncertain.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Gabriel, R. A. et al. Ten-year detection rate of brain arteriovenous malformations in a large, multiethnic, defined population. Stroke 41, 21–26 (2010).
Etminan, N. et al. Multidisciplinary consensus on assessment of unruptured intracranial aneurysms: proposal of an international research group. Stroke 45, 1523–1530 (2014).
Thompson, B. G. et al. Guidelines for the management of patients with unruptured intracranial aneurysms: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke http://dx.doi.org/10.1161/STR.0000000000000070.
Korja, M., Lehto, H. & Juvela, S. Lifelong rupture risk of intracranial aneurysms depends on risk factors: a prospective Finnish cohort study. Stroke 45, 1958–1963 (2014).
Morita, A. et al. The natural course of unruptured cerebral aneurysms in a Japanese cohort. N. Engl. J. Med. 366, 2474–2482 (2012).
Backes, D. et al. PHASES score for prediction of intracranial aneurysm growth. Stroke 46, 1221–1226 (2015).
Edjlali, M. et al. Does aneurysmal wall enhancement on vessel wall MRI help to distinguish stable from unstable intracranial aneurysms? Stroke 45, 3704–3706 (2014).
Etminan, N. et al. The Unruptured Intracranial Aneurysm Treatment Score (UIATS): a multidisciplinary consensus. Neurology (in press).
Greving, J. P. et al. Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies. Lancet Neurol. 13, 59–66 (2014).
Koffijberg, H., Buskens, E., Algra, A., Wermer, M. J. & Rinkel, G. J. Growth rates of intracranial aneurysms: exploring constancy. J. Neurosurg. 109, 176–185 (2008).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing financial interests.
Rights and permissions
About this article
Cite this article
Etminan, N., Rinkel, G. Cerebral aneurysm guidelines—more guidance needed. Nat Rev Neurol 11, 490–491 (2015). https://doi.org/10.1038/nrneurol.2015.146
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrneurol.2015.146
This article is cited by
-
Wall enhancement as a biomarker of intracranial aneurysm instability: a histo-radiological study
Acta Neurochirurgica (2023)
-
Application of unruptured aneurysm scoring systems to a cohort of ruptured aneurysms: are we underestimating rupture risk?
Neurosurgical Review (2021)
-
Wall enhancement of intracranial unruptured aneurysm is associated with increased rupture risk and traditional risk factors
European Radiology (2018)
-
Intracranial Aneurysm: Diagnostic Monitoring, Current Interventional Practices, and Advances
Current Treatment Options in Cardiovascular Medicine (2018)
-
Unruptured intracranial aneurysms: development, rupture and preventive management
Nature Reviews Neurology (2016)