Unruptured cerebral aneurysms do not shrink when they rupture: multicenter collaborative aneurysm study group.

Abstract:

BACKGROUND:The International Study of Intracranial Aneurysms found that for patients with no previous history of subarachnoid hemorrhage, small (< 7 mm) anterior circulation and posterior circulation aneurysms had a 0% and 2.5% risk of subarachnoid hemorrhage over 5 years, respectively. OBJECTIVE:To determine whether cerebral aneurysms shrink with rupture. METHODS:The clinical databases of 7 sites were screened for patients with imaging of cerebral aneurysms before and after rupture. Inclusion criteria included documented subarachnoid hemorrhage by imaging or lumbar puncture and intracranial imaging before and after cerebral aneurysm rupture. The patients were evaluated for aneurysm maximal height, maximal width, neck diameter, and other measurement parameters. Only a change of ≥ 2 mm was considered a true change. RESULTS:Data on 13 patients who met inclusion criteria were collected. The median age was 60, and 11 of the 13 patients (84.6%) were female. Only 5 patients had posterior circulation aneurysms. None of the aneurysms had a significant decrease in size. One aneurysm decreased by 1.8 mm in maximum size after rupture (7.7%). Six aneurysms had an increase in maximum size of at least 2 mm after rupture (46.2%) with a mean increase of 3.5 mm (± 0.5 mm). CONCLUSION:Unruptured aneurysms do not shrink when they rupture. The large percentage of ruptured small aneurysms in previous studies were likely small before they ruptured.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Rahman M,Ogilvy CS,Zipfel GJ,Derdeyn CP,Siddiqui AH,Bulsara KR,Kim LJ,Riina HA,Mocco J,Hoh BL

doi

10.1227/NEU.0b013e3181ff357c

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

155-60; discussion 160-1

issue

1

eissn

0148-396X

issn

1524-4040

pii

00006123-201101000-00020

journal_volume

68

pub_type

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