Froelich, JJ and Neilson, S and Peters-Wilke, J and Dubey, A and Thani, N and Erasmus, A and Carr, MW and Hunn, AWM, Size and location of ruptured intracranial aneurysms: a 5-year clinical survey, World Neurosurgery, 91 pp. 260-265. ISSN 1878-8750 (2016) [Refereed Article]
Copyright 2016 Elsevier Inc.
Background: Prospective international cohort trials have suggested that incidental cerebral aneurysms with diameters less than 10 mm are unlikely to rupture. Consequently, small ruptured cerebral aneurysms should rarely be seen in clinical practice. To verify this theory, dimensions and locations of ruptured cerebral aneurysms were analyzed across the state of Tasmania, Australia.
Methods: We retrospectively reviewed medical records and diagnostic tests of all patients admitted with ruptured cerebral aneurysms during a 5-year interval. Aneurysm location, maximum size, dome-to-neck ratio, volume, and presence of daughter sacs were determined by preoperative digital subtraction angiography or computed tomography angiography. Results A total of 131 ruptured cerebral aneurysms were encountered and treated by microsurgical clipping (n = 59) or endovascular techniques (n = 72). The mean maximum aneurysm diameter was 6.4 ± 3.7 mm, dome-to-neck ratio 2 ± 0.8, aneurysm volume 156 ± 372 mm3, and daughter sacs were present in 70 aneurysms (53.4%). The anterior communicating artery was the most common location (37.4%). Cumulative maximum diameters of ruptured aneurysms were ≤ 5 mm in 49%, ≤ 7 mm in 73%, and ≤ 10 mm in 90%.
Conclusions: Despite findings from prospective international cohort trials, small ruptured intracranial aneurysms are common in clinical practice. In consequence, it seems important to identify those patients with small but vulnerable unruptured aneurysms before conservative management is considered.
|Item Type:||Refereed Article|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Clinical sciences|
|Research Field:||Clinical sciences not elsewhere classified|
|Objective Division:||Expanding Knowledge|
|Objective Group:||Expanding knowledge|
|Objective Field:||Expanding knowledge in the health sciences|
|UTAS Author:||Froelich, JJ (Professor Jens Froelich)|
|UTAS Author:||Neilson, S (Dr Sam Neilson)|
|UTAS Author:||Dubey, A (Dr Arvind Dubey)|
|UTAS Author:||Thani, N (Mr Nova Thani)|
|UTAS Author:||Erasmus, A (Mr Albert Erasmus)|
|UTAS Author:||Hunn, AWM (Mr A Hunn)|
|Web of Science® Times Cited:||24|
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