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The Scientific World Journal
Volume 2015 (2015), Article ID 954954, 10 pages
http://dx.doi.org/10.1155/2015/954954
Review Article

Unruptured Cerebral Aneurysms: Evaluation and Management

1Department of Neurological Surgery, Division of Neurovascular Surgery and Endovascular Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA
2Department of Neurological Sciences, Division of Neurocritical Care, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA
3Department of Neurosurgery, University of Virginia, Charlottesville, VA 22903, USA

Received 17 July 2014; Revised 30 November 2014; Accepted 15 December 2014

Academic Editor: Stephen J. Monteith

Copyright © 2015 Norman Ajiboye 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

The evolution of imaging techniques and their increased use in clinical practice have led to a higher detection rate of unruptured intracranial aneurysms. The diagnosis of an unruptured intracranial aneurysm is a source of significant stress to the patient because of the concerns for aneurysmal rupture, which is associated with substantial rates of morbidity and mortality. Therefore, it is important that decisions regarding optimum management are made based on the comparison of the risk of aneurysmal rupture with the risk associated with intervention. This review provides a comprehensive overview of the epidemiology, pathophysiology, natural history, clinical presentation, diagnosis, and management options for unruptured intracranial aneurysms based on the current evidence in the literature. Furthermore, the authors discuss the genetic abnormalities associated with intracranial aneurysm and current guidelines for screening in patients with a family history of intracranial aneurysms. Since there is significant controversy in the optimum management of small unruptured intracranial aneurysms, we provided a systematic approach to their management based on patient and aneurysm characteristics as well as the risks and benefits of intervention.