Management of Unruptured Intracranial Aneurysms

Unruptured intracranial aneurysms (UIAs) are common and are being detected with increasing frequency given the improved quality and higher frequency of cross-sectional imaging. The long-term natural history of UIAs remains poorly understood. To date, there is relative lack of clear guidelines for selection of patients with UIAs for treatment. Surveillance imaging for untreated UIAs is frequently performed, but frequency, duration, and modality of surveillance imaging need clearer guidelines. The authors review the current evidence on prevalence, natural history, role of treatment, and surveillance and screening imaging and highlight the areas for further research.