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Updated: Jan 28, 2026

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Size at Which Aneurysms Rupture: A Hospital-Based Retrospective Cohort From 3 Decades.

Jeremias Tarkiainen1, Milla Kelahaara1, Liisa Pyysalo1

  • 1Department of Neurosurgery Tampere University Hospital and University of Tampere Tampere Finland.

Stroke (Hoboken, N.J.)
|January 26, 2026
PubMed
Summary
This summary is machine-generated.

Intracranial aneurysms (IAs) are rupturing at smaller sizes than previously observed, with over half rupturing below 7 mm. This suggests that IA size alone should not exclude patients from prophylactic treatment.

Keywords:
intracranial aneurysmrupturesizesubarachnoid hemorrhagetemporal trends

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Area of Science:

  • Neurosurgery
  • Radiology
  • Epidemiology

Background:

  • Saccular intracranial aneurysm (IA) size is a primary indicator for rupture risk.
  • This study investigates the rupture size of IAs and its temporal changes.

Purpose of the Study:

  • To determine the size at which intracranial aneurysms (IAs) rupture.
  • To analyze if the rupture size of IAs has changed over time.
  • To assess the implications for prophylactic treatment decisions.

Main Methods:

  • Retrospective analysis of patients with ruptured IAs from the Tampere University Hospital Aneurysm Database.
  • IA size at rupture measured via computed tomographic angiography or digital subtraction angiography.
  • Collection of clinical risk factors for rupture from patient medical records.

Main Results:

  • Of 1925 ruptured IAs with measurable size, 51% ruptured at <7 mm.
  • Mean and median IA rupture size decreased from 1989-1997, then stabilized.
  • 35% of small ruptured IAs were in the anterior communicating artery; 46% of patients lacked known risk factors.

Conclusions:

  • Small IA size should not preclude prophylactic treatment.
  • The decreasing trend in rupture size suggests evolving risk factors or patient population characteristics.