Unruptured Cerebral Aneurysms: Evaluation and Management

Area of Science:

• Neurology
• Neurosurgery
• Radiology

Background:

• Advances in imaging have increased the detection of unruptured intracranial aneurysms (UIAs).
• UIA diagnosis causes patient anxiety due to rupture risks, morbidity, and mortality.
• Optimal management requires balancing UIA rupture risk with intervention risks.

Purpose of the Study:

• To provide a comprehensive review of UIAs, covering epidemiology, pathophysiology, natural history, and clinical presentation.
• To discuss current diagnosis and management options for UIAs based on available evidence.
• To outline a systematic approach for managing small UIAs, considering patient and aneurysm factors.

Main Methods:

• Literature review of current evidence on unruptured intracranial aneurysms.
• Analysis of genetic factors and screening guidelines for familial intracranial aneurysms.
• Systematic approach development for small UIA management.

Main Results:

• The review synthesizes current knowledge on UIA epidemiology, natural history, and clinical presentation.
• Genetic abnormalities and screening guidelines for familial UIAs are discussed.
• A systematic approach to managing small UIAs is proposed, weighing intervention risks and benefits.

Conclusions:

• Informed decisions for UIA management require comparing rupture risk with intervention risks.
• Current evidence supports a systematic approach to managing small UIAs based on individual characteristics.
• Further research is needed to refine management strategies for UIAs.