A Review of the Current Literature on Cerebral Aneurysms

Cerebral aneurysms may be classified by type, size, location, and ruptured versus unruptured status. Each type of aneurysm has associated epidemiology, pathophysiology, clinical features, diagnostic protocols, management strategies, and prognoses. Optimization of clinical outcomes requires an in-depth understanding of each of these factors for a given aneurysm type, in combination with a tailored approach for each patient. This review will encompass six different types of intracranial aneurysms: saccular, fusiform, dissecting, mycotic, marantic and blister aneurysms. The clinical presentation of each aneurysm type varies based on its underlying etiology as well as its rupture status, and may range from asymptomatic to hemorrhage. Diagnostic tools generally include imaging with some combination of computerized tomography, magnetic resonance imaging, and angiography, in addition to investigations appropriate for the underlying cause. Management consists of a combination of medical and possible surgical interventions tailored to the unique characteristics of each aneurysm and patient. Lastly, prognosis varies widely and is dependent upon a number of factors, including but not limited to aneurysm type, rupture status, intervention modality, development of complications, and patient demographics and comorbidities. While abundant literature on the more common cerebral aneurysmal types of saccular, fusiform, and mycotic exists, little is available on the remaining three. Additionally, the six subtypes have rarely been summarized together in one review paper with succinct differentiations and comparisons. Having an in-depth understanding of each cerebral aneurysm type, their similarities and differences, and the interplay of patient specific factors will help guide medical and surgical intervention and allow providers to more accurately disseminate patient prognosis. We aim to summarize the current literature on cerebral aneurysms in order to inform clinical decision making and optimize patient outcomes.