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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
Unruptured cerebral aneurysms do not shrink when they rupture: multicenter collaborative aneurysm study group.
Maryam Rahman1, Christopher S Ogilvy, Gregory J Zipfel
1Department of Neurosurgery, University of Florida, Gainesville, Florida 32610, USA. maryam.rahman@neurosurgery.ufl.edu
Neurosurgery
|December 15, 2010
Summary
Cerebral aneurysms do not shrink after rupture. Most ruptured aneurysms did not decrease in size, and some even grew larger, suggesting they were small before rupture.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Small (< 7 mm) anterior and posterior circulation aneurysms have low 5-year rupture risks (0% and 2.5%) in patients without prior subarachnoid hemorrhage.
- Previous studies suggested a high proportion of ruptured aneurysms were small.
Purpose of the Study:
- To investigate whether cerebral aneurysms decrease in size following rupture.
Main Methods:
- Retrospective analysis of 7 clinical databases for patients with pre- and post-rupture aneurysm imaging.
- Inclusion criteria: documented subarachnoid hemorrhage and imaging before and after rupture.
- Aneurysm dimensions (height, width, neck) were measured; a change of ≥ 2 mm defined a true size change.
Main Results:
- Data from 13 patients (median age 60, 84.6% female) were analyzed.
- None of the aneurysms showed a significant size decrease post-rupture; one decreased by 1.8 mm (7.7%).
- Six aneurysms (46.2%) increased in maximum size by ≥ 2 mm post-rupture, with a mean increase of 3.5 mm.
Conclusions:
- Cerebral aneurysms do not shrink after rupture.
- The prevalence of small ruptured aneurysms in prior research likely reflects their pre-rupture size, not post-rupture shrinkage.
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