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Published on: August 11, 2015
Risk Analysis of Unruptured Intracranial Aneurysms: Prospective 10-Year Cohort Study.
Yuichi Murayama1, Hiroyuki Takao2, Toshihiro Ishibashi2
1From the Division of Endovascular Neurosurgery, Department of Neurosurgery (Y.M., H.T., T.I., T.S., M.E., I.Y., H.A., K.I.) and Division of Molecular Epidemiology (M.U.), The Jikei University School of Medicine, Tokyo, Japan; and Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom (A.J.M.). ymurayama@jikei.ac.jp.
Unruptured intracranial aneurysms pose risks, with larger sizes significantly increasing rupture likelihood and poor outcomes. Ethnic factors may also influence rupture risk.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- The natural history and management of unruptured intracranial aneurysms are not fully understood.
- Defining risk factors for aneurysm rupture is crucial for clinical decision-making.
Purpose of the Study:
- To evaluate the natural history of unruptured intracranial aneurysms.
- To identify predictors of aneurysm rupture, mortality, and morbidity.
Main Methods:
- Analysis of 2897 aneurysms in 2252 patients managed conservatively between 2003-2012.
- 3D imaging (CTA, DSA, MRA) for precise aneurysm evaluation.
- Assessment of rupture risk based on aneurysm characteristics, demographics, and risk factors.
Main Results:
- Overall rupture rate of 0.76% per year observed over 7388 aneurysm-years.
- Aneurysm size (≥5 mm vs. 2-4 mm), location, daughter sac, and prior subarachnoid hemorrhage were independent predictors of rupture.
- Rupture of large/giant aneurysms led to 69% mortality, with 52% of all ruptures resulting in death or severe disability.
Conclusions:
- Larger intracranial aneurysms carry a significantly higher risk of rupture and adverse outcomes.
- Ethnic background may influence the risk of aneurysm rupture.
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