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Aneurysm observation versus intervention: a literature review
Patrick J Connolly1, José Biller, Michael B Pritz
1Section of Neurosurgery, Indiana University School of Medicine, Indianapolis 46202, USA. patrconn@iupui.edu
Neurological Research
|June 21, 2002
Summary
Screening for intracranial aneurysms may benefit individuals with a family history of subarachnoid hemorrhage (SAH). Larger or symptomatic aneurysms indicate increased SAH risk and warrant treatment consideration.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Radiology
Background:
- Aneurysmal subarachnoid hemorrhage (SAH) is a critical neurological condition.
- Advances in noninvasive vascular imaging have improved diagnosis of unruptured intracranial aneurysms.
Purpose of the Study:
- To identify individuals who would benefit from screening for intracranial aneurysms.
- To discuss current risk factors and treatment considerations for aneurysmal SAH.
Main Methods:
- Review of current literature on intracranial aneurysms and subarachnoid hemorrhage.
- Analysis of risk factors including family history, aneurysm size, and symptoms.
- Exploration of decision analysis models for treatment strategies.
Main Results:
- Mass screening for aneurysms is not cost-effective.
- Individuals with multiple affected relatives are prime candidates for screening.
- Aneurysms >10 mm or symptomatic aneurysms are associated with significantly increased SAH risk.
Conclusions:
- Targeted screening is recommended for high-risk individuals, particularly those with a strong family history of SAH.
- Treatment is indicated for larger or symptomatic aneurysms, though optimal methods require further investigation.
- Prospective clinical trials are needed to validate treatment models for specific patient groups.
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