Clinical practice guideline for the management of intracranial aneurysms

Hae Woong Jeong1, Jung Hwa Seo2, Sung Tae Kim3

  • 1Department of Radiology, Busan Paik Hospital, Inje University, Busan, Korea.

Neurointervention
|November 27, 2014
PubMed

Insights

This guideline offers evidence-based recommendations for managing intracranial aneurysms, both ruptured and unruptured. It covers diagnosis, treatment, and risk assessment for these critical vascular conditions.

Area of Science:

  • Neurosurgery
  • Neuroradiology
  • Vascular Neurology

Background:

  • Intracranial aneurysms pose significant health risks, whether ruptured (causing subarachnoid hemorrhage) or unruptured.
  • Both ruptured and unruptured intracranial aneurysms cause considerable patient anxiety and require careful management strategies.

Purpose of the Study:

  • To provide comprehensive, current recommendations for the clinical management of intracranial aneurysms.
  • To address both ruptured intracranial aneurysms (RIAs) and unruptured intracranial aneurysms (UIAs) in a unified guideline.

Main Methods:

  • An extensive literature search was conducted using the Medline database.
  • Recommendations were developed through in-person discussions by the Task Force Team of the Korean Society of Interventional Neuroradiology (KSIN).

Main Results:

  • The guideline is structured into separate sections for RIAs and UIAs.
  • For RIAs, the focus is on diagnosis and treatment protocols.
  • For UIAs, recommendations cover high-risk patient identification, screening, and treatment principles/selection.

Conclusions:

  • This guideline offers practical, evidence-based advice for managing patients with intracranial aneurysms.
  • It aims to standardize and improve care for individuals affected by these cerebrovascular conditions.
Abstract

Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
468
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
610
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
564
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
650
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
562
Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component...
1