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11:58
Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
Incidental intracranial aneurysms: rationale for treatment
1Interventional Neuroradiology Research Unit, Department of Radiology, Centre hospitalier de l'Université de Montréal, Notre-Dame Hospital, Montreal, Canada. dr_jean_raymond@hotmail.com
Current Opinion in Neurology
|January 27, 2009
Summary
Current evidence on treating incidental intracranial aneurysms is insufficient. Poor quality studies and modest risk factors fail to justify treatments, necessitating randomized trials for better data.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Incidental intracranial aneurysms are frequently discovered during neuroimaging.
- Treatment decisions are often based on limited evidence and risk-benefit analyses.
Purpose of the Study:
- To critically appraise the evidence and rationale for treating incidental intracranial aneurysms.
- To evaluate the current justification for intervention in unruptured aneurysms.
Main Methods:
- Systematic review of existing literature.
- Analysis of meta-analyses on aneurysm natural history and treatment risks.
- Identification of risk factors for aneurysm rupture.
Main Results:
- Risk factors for rupture include age >60, female sex, aneurysm size >5 mm, and posterior circulation location.
- The quality of studies identifying these risk factors is poor.
- Relative risks for rupture are modest and of borderline statistical significance.
Conclusions:
- Existing medical literature lacks reliable data for predictive models of treatment benefits.
- Current rationale is insufficient to justify the increasing use of treatments for incidental aneurysms.
- Randomized controlled trials are needed to establish evidence-based treatment guidelines.
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