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International Journal of Vascular Medicine
Volume 2012 (2012), Article ID 898052, 11 pages
http://dx.doi.org/10.1155/2012/898052
Review Article

The Natural History and Treatment Options for Unruptured Intracranial Aneurysms

1Department of Neurological Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, NJ 07101, USA
2Department of Radiology, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, NJ 07101, USA
3Department of Neurology & Neuroscience, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, NJ 07101, USA

Received 15 August 2011; Revised 27 November 2011; Accepted 5 December 2011

Academic Editor: Mario Zuccarello

Copyright © 2012 Joshua E. Loewenstein et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Recent advances in angiographic technique have raised our awareness of the presence of unruptured intracranial aneurysms (UIAs). However, the appropriate management for these lesions remains controversial. To optimize patient outcomes, the physician must weigh aneurysmal rupture risk associated with observation against the complication risks associated with intervention. In the case that treatment is chosen, the two available options are surgical clipping and endovascular coiling. Our paper summarizes the current body of literature in regards to the natural history of UIAs, the evolution of the lesion if it progresses uninterrupted, as well as the safety and efficacy of both treatment options. The risks and benefits of treatment and conservative management need to be evaluated on an individual basis and are greatly effected by both patient-specific and aneurysm-specific factors, which are presented in this paper. Ultimately, this body of data has led to multiple sets of treatment guidelines, which we have summated and presented in this paper.