Table of Contents Author Guidelines Submit a Manuscript
The Scientific World Journal
Volume 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.

Linked References

  1. J. Jakubowski and B. Kendall, “Coincidental aneurysms with tumours of pituitary origin,” Journal of Neurology, Neurosurgery & Psychiatry, vol. 41, no. 11, pp. 972–979, 1978. View at Publisher · View at Google Scholar · View at Scopus
  2. E. S. Connolly and R. A. Solomon, “Management of unruptured aneurysms,” in Management of Cerebral Aneurysms, P. D. Le Roux, H. R. Winn, and D. W. Newell, Eds., pp. 271–285, Saunders, Philadelphia, Pa, USA, 2004. View at Google Scholar
  3. J. L. Chason and W. M. Hindman, “Berry aneurysms of the circle of Willis; results of a planned autopsy study,” Neurology, vol. 8, no. 1, pp. 41–44, 1958. View at Google Scholar · View at Scopus
  4. W. I. Schievink, “Intracranial aneurysms,” The New England Journal of Medicine, vol. 336, no. 1, pp. 28–40, 1997. View at Publisher · View at Google Scholar · View at Scopus
  5. W. I. Schievink, “Erratum in “Intracranial aneurysms”,” The New England Journal of Medicine, vol. 336, p. 1267, 1997. View at Google Scholar
  6. D. J. Nieuwkamp, L. E. Setz, A. Algra, F. H. Linn, N. K. de Rooij, and G. J. Rinkel, “Changes in case fatality of aneurysmal subarachnoid haemorrhage over time, according to age, sex, and region: a meta-analysis,” The Lancet Neurology, vol. 8, no. 7, pp. 635–642, 2009. View at Publisher · View at Google Scholar · View at Scopus
  7. L. N. Williams and R. D. Brown, “Management of unruptured intracranial aneurysms,” Neurology: Clinical Practice, vol. 3, no. 2, pp. 99–108, 2013. View at Publisher · View at Google Scholar · View at Scopus
  8. A. Ronkainen, H. Miettinen, K. Karkola et al., “Risk of harboring an unruptured intracranial aneurysm,” Stroke, vol. 29, no. 2, pp. 359–362, 1998. View at Publisher · View at Google Scholar · View at Scopus
  9. V. S. Alg, R. Sofat, H. Houlden, and D. J. Werring, “Genetic risk factors for intracranial aneurysms: a meta-analysis in more than 116,000 individuals,” Neurology, vol. 80, no. 23, pp. 2154–2165, 2013. View at Publisher · View at Google Scholar · View at Scopus
  10. R. M. Starke, G. H. Kim, A. Fernandez et al., “Impact of a protocol for acute antifibrinolytic therapy on aneurysm rebleeding after subarachnoid hemorrhage,” Stroke, vol. 39, no. 9, pp. 2617–2621, 2008. View at Publisher · View at Google Scholar · View at Scopus
  11. J. P. Greving, M. J. H. Wermer, R. D. Brown et al., “Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies,” The Lancet Neurology, vol. 13, no. 1, pp. 59–66, 2014. View at Publisher · View at Google Scholar · View at Scopus
  12. D. O. Wiebers, “Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment,” The Lancet, vol. 362, no. 9378, pp. 103–110, 2003. View at Publisher · View at Google Scholar · View at Scopus
  13. S. Juvela, K. Poussa, H. Lehto, and M. Porras, “Natural history of unruptured intracranial aneurysms: a long-term follow-up study,” Stroke, vol. 44, no. 9, pp. 2414–2421, 2013. View at Publisher · View at Google Scholar · View at Scopus
  14. A. Morita, T. Kirino, K. Hashi et al., “The natural course of unruptured cerebral aneurysms in a Japanese cohort,” The New England Journal of Medicine, vol. 366, no. 26, pp. 2474–2782, 2012. View at Publisher · View at Google Scholar · View at Scopus
  15. D. O. Wiebers, J. P. Whisnant, J. Huston III et al., “Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment,” The Lancet, vol. 362, pp. 103–110, 2003. View at Google Scholar
  16. G. W. Britz, L. Salem, D. W. Newell, J. Eskridge, and D. R. Flum, “Impact of surgical clipping on survival in unruptured and ruptured cerebral aneurysms: a population-based study,” Stroke, vol. 35, no. 6, pp. 1399–1403, 2004. View at Publisher · View at Google Scholar · View at Scopus
  17. C. S. Ogilvy, B. S. Carter, R. A. Solomon, D. L. Barrow, H. H. Batjer, and S. L. Giannotta, “Stratification of outcome for surgically treated unruptured intracranial aneurysms,” Neurosurgery, vol. 52, no. 1, pp. 82–88, 2003. View at Publisher · View at Google Scholar · View at Scopus
  18. J. Moroi, H. Hadeishi, A. Suzuki, and N. Yasui, “Morbidity and mortality from surgical treatment of unruptured cerebral aneurysms at Research Institute for Brain and Blood Vessels-Akita,” Neurosurgery, vol. 56, no. 2, pp. 224–231, 2005. View at Publisher · View at Google Scholar · View at Scopus
  19. M. Kotowski, O. Naggara, T. E. Darsaut et al., “Safety and occlusion rates of surgical treatment of unruptured intracranial aneurysms: a systematic review and meta-analysis of the literature from 1990 to 2011,” Journal of Neurology, Neurosurgery & Psychiatry, vol. 84, no. 1, pp. 42–48, 2013. View at Publisher · View at Google Scholar · View at Scopus
  20. O. N. Naggara, A. Lecler, C. Oppenheim, J.-F. Meder, and J. Raymond, “Endovascular treatment of intracranial unruptured aneurysms: a systematic review of the literature on safety with emphasis on subgroup analyses,” Radiology, vol. 263, no. 3, pp. 828–835, 2012. View at Publisher · View at Google Scholar · View at Scopus
  21. L. Pierot, L. Spelle, and F. Vitry, “Immediate clinical outcome of patients harboring unruptured intracranial aneurysms treated by endovascular approach: results of the ATENA study,” Stroke, vol. 39, no. 9, pp. 2497–2504, 2008. View at Publisher · View at Google Scholar · View at Scopus
  22. Y. Murayama, Y. L. Nien, G. Duckwiler et al., “Guglielmi detachable coil embolization of cerebral aneurysms: 11 Years' experience,” Journal of Neurosurgery, vol. 98, no. 5, pp. 959–966, 2003. View at Publisher · View at Google Scholar · View at Scopus
  23. V. Beneš, P. Mitchell, A. J. Molyneux, and S. A. Renowden, “Endovascular coiling in 131 patients with low complication rate justifies treating most unruptured intracranial aneurysms,” Zentralblatt für Neurochirurgie, vol. 71, no. 1, pp. 1–7, 2010. View at Publisher · View at Google Scholar · View at Scopus
  24. A. Alshekhlee, S. Mehta, R. C. Edgell et al., “Hospital mortality and complications of electively clipped or coiled unruptured intracranial aneurysm,” Stroke, vol. 41, no. 7, pp. 1471–1476, 2010. View at Publisher · View at Google Scholar · View at Scopus
  25. J. S. McDonald, R. J. McDonald, J. Fan, D. F. Kallmes, G. Lanzino, and H. J. Cloft, “Comparative effectiveness of unruptured cerebral aneurysm therapies: propensity score analysis of clipping versus coiling,” Stroke, vol. 44, no. 4, pp. 988–994, 2013. View at Publisher · View at Google Scholar · View at Scopus
  26. M. J. H. Wermer, I. C. van der Schaaf, A. Algra, and G. J. E. Rinkel, “Risk of rupture of unruptured intracranial aneurysms in relation to patient and aneurysm characteristics: an updated meta-analysis,” Stroke, vol. 38, no. 4, pp. 1404–1410, 2007. View at Publisher · View at Google Scholar · View at Scopus
  27. M. Schmidt, M. B. Johansen, T. L. Lash, C. F. Christiansen, S. Christensen, and H. T. Sørensen, “Antiplatelet drugs and risk of subarachnoid hemorrhage: a population-based case-control study,” Journal of Thrombosis and Haemostasis, vol. 8, no. 7, pp. 1468–1474, 2010. View at Publisher · View at Google Scholar · View at Scopus
  28. L. G. Toussaint III, J. A. Friedman, E. F. M. Wijdicks et al., “Influence of aspirin on outcome following aneurysmal subarachnoid hemorrhage,” Journal of Neurosurgery, vol. 101, no. 6, pp. 921–925, 2004. View at Publisher · View at Google Scholar · View at Scopus
  29. N. Tarlov, A. M. Norbash, and T. N. Nguyen, “The safety of anticoagulation in patients with intracranial aneurysms,” Journal of NeuroInterventional Surgery, vol. 5, no. 5, pp. 405–409, 2013. View at Publisher · View at Google Scholar · View at Scopus
  30. R. D. Brown and J. P. Broderick, “Unruptured intracranial aneurysms: epidemiology, natural history, management options, and familial screening,” The Lancet Neurology, vol. 13, no. 4, pp. 393–404, 2014. View at Publisher · View at Google Scholar
  31. D. M. Hasan, K. B. Mahaney, R. D. Brown et al., “Aspirin as a promising agent for decreasing incidence of cerebral aneurysm rupture,” Stroke, vol. 42, no. 11, pp. 3156–3162, 2011. View at Publisher · View at Google Scholar · View at Scopus
  32. J. L. Brisman, J. K. Song, and D. W. Newell, “Cerebral aneurysms,” The New England Journal of Medicine, vol. 355, no. 9, pp. 928–939, 2006. View at Publisher · View at Google Scholar · View at Scopus
  33. J. P. Broderick, R. D. Brown Jr., L. Sauerbeck et al., “Greater rupture risk for familial as compared to sporadic unruptured intracranial aneurysms,” Stroke, vol. 40, no. 6, pp. 1952–1957, 2009. View at Publisher · View at Google Scholar · View at Scopus
  34. J. van Gijn, R. S. Kerr, and G. J. Rinkel, “Subarachnoid haemorrhage,” The Lancet, vol. 369, no. 9558, pp. 306–318, 2007. View at Publisher · View at Google Scholar · View at Scopus
  35. D. O. Wiebers, J. P. Whisnant, T. M. Sundt Jr., and W. M. O'Fallon, “The significance of unruptured intracranial saccular aneurysms,” Journal of Neurosurgery, vol. 66, no. 1, pp. 23–29, 1987. View at Publisher · View at Google Scholar · View at Scopus
  36. W. Brinjikji, A. A. Rabinstein, D. M. Nasr, G. Lanzino, D. F. Kallmes, and H. J. Cloft, “Better outcomes with treatment by coiling relative to clipping of unruptured intracranial aneurysms in the United States, 2001–2008,” American Journal of Neuroradiology, vol. 32, no. 6, pp. 1071–1075, 2011. View at Publisher · View at Google Scholar · View at Scopus
  37. J. P. Villablanca, G. R. Duckwiler, R. Jahan et al., “Natural history of asymptomatic unruptured cerebral aneurysms evaluated at CT angiography: growth and rupture incidence and correlation with epidemiologic risk factors,” Radiology, vol. 269, no. 1, pp. 258–265, 2013. View at Publisher · View at Google Scholar · View at Scopus
  38. S. Dammert, T. Krings, E. Ueffing et al., “Detection of intracranial aneurysms with multislice CT: comparison with conventional angiography,” Neuroradiology, vol. 46, no. 6, pp. 427–434, 2004. View at Google Scholar · View at Scopus
  39. P. Morris, Practical Neuroangiography, Williams & Wilkins, Baltimore, Md, USA, 1997.
  40. E. T. Chappell, F. C. Moure, M. C. Good et al., “Comparison of computed tomographic angiography with digital subtraction angiography in the diagnosis of cerebral aneurysms: a meta-analysis,” Neurosurgery, vol. 52, no. 3, pp. 624–631, 2003. View at Google Scholar · View at Scopus
  41. P. M. White, J. M. Wardlaw, and V. Easton, “Can noninvasive imaging accurately depict intracranial aneurysms? A systematic review,” Radiology, vol. 217, no. 2, pp. 361–370, 2000. View at Publisher · View at Google Scholar · View at Scopus
  42. P. M. White, E. M. Teasdale, J. M. Wardlaw, and V. Easton, “Intracranial aneurysms: CT angiography and MR angiography for detection—prospective blinded comparison in a large patient cohort,” Radiology, vol. 219, no. 3, pp. 739–749, 2001. View at Publisher · View at Google Scholar · View at Scopus
  43. G. J. Rinkel, “Intracranial aneurysm screening: indications and advice for practice,” The Lancet Neurology, vol. 4, no. 2, pp. 122–128, 2005. View at Publisher · View at Google Scholar · View at Scopus
  44. J. D. Burns, J. Huston III, K. F. Layton, D. G. Piepgras, and R. D. Brown Jr., “Intracranial aneurysm enlargement on serial magnetic resonance angiography: frequency and risk factors,” Stroke, vol. 40, no. 2, pp. 406–411, 2009. View at Publisher · View at Google Scholar · View at Scopus
  45. N. Miyazawa, I. Akiyama, and Z. Yamagata, “Risk factors for growth of unruptured intracranial aneurysms: follow-up study by serial 0.5-T magnetic resonance angiography,” Neurosurgery, vol. 58, no. 6, pp. 1047–1052, 2006. View at Publisher · View at Google Scholar · View at Scopus
  46. C. A. David, A. G. Vishteh, R. F. Spetzler, M. Lemole, M. T. Lawton, and S. Partovi, “Late angiographic follow-up review of surgically treated aneurysms,” Journal of Neurosurgery, vol. 91, no. 3, pp. 396–401, 1999. View at Publisher · View at Google Scholar · View at Scopus
  47. J. van Gijn and G. J. E. Rinkel, “Subarachnoid haemorrhage: diagnosis, causes and management,” Brain, vol. 124, no. 2, pp. 249–278, 2001. View at Publisher · View at Google Scholar · View at Scopus
  48. S. Matsubara, H. Hadeishi, A. Suzuki, N. Yasui, and H. Nishimura, “Incidence and risk factors for the growth of unruptured cerebral aneurysms: observation using serial computerized tomography angiography,” Journal of Neurosurgery, vol. 101, no. 6, pp. 908–914, 2004. View at Publisher · View at Google Scholar · View at Scopus
  49. J. T. King Jr., J. A. Berlin, and E. S. Flamm, “Morbidity and mortality from elective surgery for asymptomatic, unruptured, intracranial aneurysms: a meta-analysis,” Journal of Neurosurgery, vol. 81, no. 6, pp. 837–842, 1994. View at Publisher · View at Google Scholar · View at Scopus
  50. T. W. M. Raaymakers, G. J. E. Rinkel, M. Limburg, and A. Algra, “Mortality and morbidity of surgery for unruptured intracranial aneurysms: a meta-analysis,” Stroke, vol. 29, no. 8, pp. 1531–1538, 1998. View at Publisher · View at Google Scholar · View at Scopus
  51. M. Korja, H. Lehto, and S. Juvela, “Lifelong rupture risk of intracranial aneurysms depends on risk factors: a prospective finnish cohort study,” Stroke, vol. 45, pp. 1985–1963, 2014. View at Publisher · View at Google Scholar · View at Scopus
  52. Z. Dovey, M. Misra, J. Thornton, F. T. Charbel, G. M. Debrun, and J. I. Ausman, “Guglielmi detachable coiling for intracranial aneurysms: the story so far,” Archives of Neurology, vol. 58, no. 4, pp. 559–564, 2001. View at Google Scholar · View at Scopus
  53. D. F. Kallmes, R. Hanel, D. Lopes et al., “International retrospective study of the pipeline embolization device: a multicenter aneurysm treatment study,” The American Journal of Neuroradiology, 2014. View at Publisher · View at Google Scholar
  54. A. J. Molyneux, S. Cekirge, I. Saatci, and G. Gál, “Cerebral Aneurysm Multicenter European Onyx (CAMEO ) trial: results of a prospective observational study in 20 European centers,” American Journal of Neuroradiology, vol. 25, no. 1, pp. 39–51, 2004. View at Google Scholar · View at Scopus
  55. J. S. Hwang, M. K. Hyun, H. J. Lee et al., “Endovascular coiling versus neurosurgical clipping in patients with unruptured intracranial aneurysm: a systematic review,” BMC Neurology, vol. 12, article 99, 2012. View at Publisher · View at Google Scholar · View at Scopus
  56. J. A. Friedman, D. A. Nichols, F. B. Meyer et al., “Guglielmi detachable coil treatment of ruptured saccular cerebral aneurysms: retrospective review of a 10-year single-center experience,” American Journal of Neuroradiology, vol. 24, no. 3, pp. 526–533, 2003. View at Google Scholar · View at Scopus