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Ruptured de novo intracranial aneurysms
1Department of Neurosurgery, Yamagata Prefecture Central Hospital, 1800 Aoyagi, Yamagata 990-2292, Japan. yone@bri.niigata-u.ac.jp
Acta Neurochirurgica
|September 2, 2004
Summary
Ruptured de novo intracranial aneurysms are rare but can occur years after initial treatment. Early screening, especially for women, is recommended to detect these secondary aneurysms before rupture.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Radiology
Background:
- Intracranial aneurysms require careful follow-up after treatment.
- De novo intracranial aneurysms, forming after initial treatment, present a unique clinical challenge.
Purpose of the Study:
- To characterize the clinical presentation and outcomes of ruptured de novo intracranial aneurysms.
- To inform guidelines for the follow-up of patients with treated intracranial aneurysms.
Main Methods:
- Retrospective analysis of 12 cases of ruptured de novo aneurysms from 483 patients with aneurysmal subarachnoid hemorrhage.
- Review of patient history, aneurysm characteristics, and treatment outcomes over a 22-year period.
Main Results:
- De novo aneurysms occurred in 2.5% of patients, predominantly in women, with a mean interval of 10.7 years between ruptures.
- Risk factors were absent in some cases, and new aneurysms did not occur at the same site as the original lesion.
- 75% of de novo aneurysms could potentially be detected before rupture with timely screening.
Conclusions:
- Late-phase screening with angiography or less-invasive imaging is advised for patients with treated aneurysms, particularly women.
- Screening for de novo aneurysms should be considered within approximately 6.39 years after the last negative examination.
- Proactive surveillance can improve the detection rates of de novo intracranial aneurysms, potentially preventing rupture.