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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
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Advances in screening and management of unruptured intracranial aneurysms

Gabriel J E Rinkel1, Ynte M Ruigrok2, Timo Krings3

  • 1Department of Neurology and Neurosurgery, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands; Department of Neurosurgery, University Hospital and Medical Faculty Mannheim, Mannheim, Germany.

The Lancet. Neurology
|October 18, 2025
PubMed

Insights

Managing unruptured intracranial aneurysms is complex. Recent advances enable personalized screening and treatment strategies, but uncertainties remain regarding long-term benefits and effectiveness.

Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Unruptured intracranial aneurysms (UIAs) present complex clinical management challenges.
  • Recent studies focus on screening high-risk populations, including those with family history, genetic disorders, smoking, and hypertension.
  • Advances in prediction models aid in risk assessment for complications, growth, and rupture.

Purpose of the Study:

  • To review the evolving strategies for screening and managing unruptured intracranial aneurysms.
  • To highlight the shift towards personalized medicine in UIA management.
  • To identify remaining uncertainties in UIA screening and treatment.

Main Methods:

  • Literature review of studies published in the last 5 years.
  • Analysis of prediction models for aneurysm complications, growth, and rupture.
  • Evaluation of screening benefits in high-risk populations.

Main Results:

  • Screening strategies are increasingly personalized based on individual risk factors.
  • Prediction models assist in estimating risks associated with preventive occlusion and aneurysm progression.
  • Personalized approaches are shifting clinical decision-making for unruptured intracranial aneurysms.

Conclusions:

  • Clinical management of unruptured intracranial aneurysms is becoming more personalized.
  • Further research is needed to clarify the value of screening in specific populations.
  • Long-term benefits of preventive occlusion and medical treatments require further investigation.

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