Angiographic frequency of anterior circulation intracranial aneurysms

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✓ A retrospective angiographic analysis was designed to extrapolate the frequency of angiographically defined asymptomatic intracranial aneurysms in the anterior circulation from a relatively unbiased clinical series. A total of 9295 angiograms were reviewed from January, 1980, to January, 1987, and, based on these, 278 patients with minimal bias for the presence of an aneurysm were selected. Three patients were found to have incidental aneurysms; thus, the angiographic frequency of patients with asymptomatic aneurysms in this series was 1%. This patient population is skewed toward the older age groups and probably over-represents the incidence of these aneurysms in the population at large. Comparing current subarachnoid hemorrhage statistics and the low frequency of asymptomatic aneurysms suggests that a larger percentage of these aneurysms than was previously thought subsequently rupture. This study contrasts sharply with previous reports quoting a high incidence of aneurysms, and significantly alters the concept and treatment of this disease.

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Address reprint requests to: John L. D. Atkinson, M.D., Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota 55905.

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References

  • 1.

    Brahme FJ: CT diagnosis of cerebrovascular disorders — a review. Comput Tomogr 2:1731811978Brahme FJ: CT diagnosis of cerebrovascular disorders — a review. Comput Tomogr 2:173–181 1978

  • 2.

    Drake CG: Management of cerebral aneurysm. Stroke 12:2732831981Drake CG: Management of cerebral aneurysm. Stroke 12:273–283 1981

  • 3.

    du Boulay GH: Some observations on the natural history of intracranial aneurysms. Br J Radiol 38:7217571965du Boulay GH: Some observations on the natural history of intracranial aneurysms. Br J Radiol 38:721–757 1965

  • 4.

    Forbes GSEarnest F IVKispert DBet al: Digital angiography. Introducing digital techniques to clinical cerebral angiography practice. Mayo Clin Proc 57:6836931982Forbes GS Earnest F IV Kispert DB et al: Digital angiography. Introducing digital techniques to clinical cerebral angiography practice. Mayo Clin Proc 57:683–693 1982

  • 5.

    Ghoshhajra KScotti LMarasco Jet al: CT detection of intracranial aneurysms in subarachnoid hemorrhage. AJR 132:6136161979Ghoshhajra K Scotti L Marasco J et al: CT detection of intracranial aneurysms in subarachnoid hemorrhage. AJR 132:613–616 1979

  • 6.

    Gökalp HZAvman NÖzkal Eet al: Brain tumour associated with intracranial arterial aneurysm. Acta Neurochir 53:2672731980Gökalp HZ Avman N Özkal E et al: Brain tumour associated with intracranial arterial aneurysm. Acta Neurochir 53:267–273 1980

  • 7.

    Hacker RJKrall JMFox JL: The incidence of intracranial aneurysm in Fox JL (ed): Intracranial Aneurysms. New York: Springer-Verlag1983 Vol 1 pp 1562Hacker RJ Krall JM Fox JL: The incidence of intracranial aneurysm in Fox JL (ed): Intracranial Aneurysms. New York: Springer-Verlag 1983 Vol 1 pp 15–62

  • 8.

    Handa JMatsuda IHanda H: Association of brain tumor and intracranial aneurysms. Surg Neurol 6:25291976Handa J Matsuda I Handa H: Association of brain tumor and intracranial aneurysms. Surg Neurol 6:25–29 1976

  • 9.

    Hayashi SArimoto TItakura Tet al: The association of intracranial aneurysms and arteriovenous malformation of the brain. Case report. J Neurosurg 55:9719751981Hayashi S Arimoto T Itakura T et al: The association of intracranial aneurysms and arteriovenous malformation of the brain. Case report. J Neurosurg 55:971–975 1981

  • 10.

    Housepian EMPool JL: A systematic analysis of intracranial aneurysms from the autopsy file of the Presbyterian Hospital. J Neuropathol Exp Neurol 17:4094231958Housepian EM Pool JL: A systematic analysis of intracranial aneurysms from the autopsy file of the Presbyterian Hospital. J Neuropathol Exp Neurol 17:409–423 1958

  • 11.

    Jakubowski JKendall B: Coincidental aneurysms with tumors of pituitary origin. J Neurol Neurosurg Psychiatry 41:9729791978Jakubowski J Kendall B: Coincidental aneurysms with tumors of pituitary origin. J Neurol Neurosurg Psychiatry 41:972–979 1978

  • 12.

    Katada KKanno TSano Het al: CT in evaluation of the circle of Willis. Neuroradiology 16:3373391978Katada K Kanno T Sano H et al: CT in evaluation of the circle of Willis. Neuroradiology 16:337–339 1978

  • 13.

    Kurtzke JF: Epidemiology of Cerebrovascular Disease. Joint Council on Cerebrovascular Disease Survey Report. Rochester, Minn: Whiting Press1980Kurtzke JF: Epidemiology of Cerebrovascular Disease. Joint Council on Cerebrovascular Disease Survey Report. Rochester Minn: Whiting Press 1980

  • 14.

    Locksley HB: Natural history of subarachnoid hemorrhage, intracranial aneurysms, and arteriovenous malformations. Based on 6,368 cases in the Cooperative Study in Sahs ALPerret GELocksley HBet al (eds): Intracranial Aneurysms and Subarachnoid Hemorrhage. A Cooperative Study. Philadelphia: JB Lippincott1969 pp 37108Locksley HB: Natural history of subarachnoid hemorrhage intracranial aneurysms and arteriovenous malformations. Based on 6368 cases in the Cooperative Study in Sahs AL Perret GE Locksley HB et al (eds): Intracranial Aneurysms and Subarachnoid Hemorrhage. A Cooperative Study. Philadelphia: JB Lippincott 1969 pp 37–108

  • 15.

    McCormick WF: Problems and pathogenesis of intracranial arterial aneurysms in Toole JFMoossy JJaneway R (eds): Cerebrovascular Disordersed 2. New York: Grune & Stratton1971 pp 219231McCormick WF: Problems and pathogenesis of intracranial arterial aneurysms in Toole JF Moossy J Janeway R (eds): Cerebrovascular Disorders ed 2. New York: Grune & Stratton 1971 pp 219–231

  • 16.

    McCormick WFAcosta-Rua GJ: The size of intracranial saccular aneurysms. An autopsy study. J Neurosurg 33:4224271970McCormick WF Acosta-Rua GJ: The size of intracranial saccular aneurysms. An autopsy study. J Neurosurg 33:422–427 1970

  • 17.

    Okada HKodama NMineura Ket al: [A ruptured aneurysm associated with pituitary tumor.] No Shinkei Geka 8:3793811980 (Jpn)Okada H Kodama N Mineura K et al: [A ruptured aneurysm associated with pituitary tumor.] No Shinkei Geka 8:379–381 1980 (Jpn)

  • 18.

    Onuma THori SSuzuki J: [Intracranial aneurysm associated with arteriovenous malformation.] No Shinkei Geka 5:115711641977 (Jpn)Onuma T Hori S Suzuki J: [Intracranial aneurysm associated with arteriovenous malformation.] No Shinkei Geka 5:1157–1164 1977 (Jpn)

  • 19.

    Perrett LVBull JWD: The accuracy of radiology in demonstrating ruptured intracranial aneurysms. Br J Radiol 32:85921959Perrett LV Bull JWD: The accuracy of radiology in demonstrating ruptured intracranial aneurysms. Br J Radiol 32:85–92 1959

  • 20.

    Phillips LHWhisnant JPO'Fallon WMet al: The unchanging pattern of subarachnoid hemorrhage in a community. Neurology 30:103410401980Phillips LH Whisnant JP O'Fallon WM et al: The unchanging pattern of subarachnoid hemorrhage in a community. Neurology 30:1034–1040 1980

  • 21.

    Pia HWObrador SMartin JG: Association of brain tumors and arterial intracranial aneurysms. Acta Neurochir 27:1892041972Pia HW Obrador S Martin JG: Association of brain tumors and arterial intracranial aneurysms. Acta Neurochir 27:189–204 1972

  • 22.

    Sahs ALNibbelink DWTomer JC (eds): Aneurysmal Subarachnoid Hemorrhage. Report of the Cooperative Study. Baltimore: Urban & Schwarzenberg1981Sahs AL Nibbelink DW Tomer JC (eds): Aneurysmal Subarachnoid Hemorrhage. Report of the Cooperative Study. Baltimore: Urban & Schwarzenberg 1981

  • 23.

    Sakai SMatsuo YKuwabara Het al: Rupture of an aneurysm into a parasellar epidermoid cyst. Case report. J Neurosurg 55:6296321981Sakai S Matsuo Y Kuwabara H et al: Rupture of an aneurysm into a parasellar epidermoid cyst. Case report. J Neurosurg 55:629–632 1981

  • 24.

    Sayama IIto ZOhta Het al: [Incidental meningioma.] No Shinkei Geka 10:7617671982 (Jpn)Sayama I Ito Z Ohta H et al: [Incidental meningioma.] No Shinkei Geka 10:761–767 1982 (Jpn)

  • 25.

    Sonesson BLjunggren BSäveland Het al: Cognition and adjustment after late and early operation for ruptured aneurysm. Neurosurgery 21:2792871987Sonesson B Ljunggren B Säveland H et al: Cognition and adjustment after late and early operation for ruptured aneurysm. Neurosurgery 21:279–287 1987

  • 26.

    Stehbens WE: Aneurysms and anatomical variation of cerebral arteries. Arch Pathol 75:45641963Stehbens WE: Aneurysms and anatomical variation of cerebral arteries. Arch Pathol 75:45–64 1963

  • 27.

    Sypert GW: Intracranial aneurysms: natural history and surgical management. Compr Ther 4:64731978Sypert GW: Intracranial aneurysms: natural history and surgical management. Compr Ther 4:64–73 1978

  • 28.

    Takayasu MShintani ANegoro Met al: The value of contrast-enhanced computed tomography for the diagnosis of intracranial aneurysms. Neurol Med Chir 25:27311985Takayasu M Shintani A Negoro M et al: The value of contrast-enhanced computed tomography for the diagnosis of intracranial aneurysms. Neurol Med Chir 25:27–31 1985

  • 29.

    Taylor PE: Delayed postoperative hemorrhage from intracranial aneurysm after craniotomy for tumor. Neurology 11:2252311961Taylor PE: Delayed postoperative hemorrhage from intracranial aneurysm after craniotomy for tumor. Neurology 11:225–231 1961

  • 30.

    US Department of Health and Human Services: Vital Statistics of the United States 1980 Volume II Parts A and B. Hyattsville, Md: National Center for Health Statistics1985US Department of Health and Human Services: Vital Statistics of the United States 1980 Volume II Parts A and B. Hyattsville Md: National Center for Health Statistics 1985

  • 31.

    Wakai SFukushima TFurihata Tet al: Association of cerebral aneurysm with pituitary adenoma. Surg Neurol 12:5035071979Wakai S Fukushima T Furihata T et al: Association of cerebral aneurysm with pituitary adenoma. Surg Neurol 12:503–507 1979

  • 32.

    Weir B: Intracranial aneurysms and subarachnoid hemorrhage: an overview in Wilkins RHRengachary SS (eds): Neurosurgery. New York: McGraw-Hill1985 Vol 2 pp 13081329Weir B: Intracranial aneurysms and subarachnoid hemorrhage: an overview in Wilkins RH Rengachary SS (eds): Neurosurgery. New York: McGraw-Hill 1985 Vol 2 pp 1308–1329

  • 33.

    Weisberg L: Direct visualization of intracranial aneurysms by computed tomography. Comput Tomogr 5:1911991981Weisberg L: Direct visualization of intracranial aneurysms by computed tomography. Comput Tomogr 5:191–199 1981

  • 34.

    Wiebers DOWhisnant JPSundt TM Jret al: The significance of unruptured intracranial saccular aneurysms. J Neurosurg 66:23291987Wiebers DO Whisnant JP Sundt TM Jr et al: The significance of unruptured intracranial saccular aneurysms. J Neurosurg 66:23–29 1987

  • 35.

    Zimmerman RDLeeds NEGoldman MJ: Digital subtraction angiography in the evaluation in patients with cerebrovascular disease in Fein JMFlamm ES (eds): Cerebrovascular Surgery. New York: Springer-Verlag1985 Vol 2 pp 343358Zimmerman RD Leeds NE Goldman MJ: Digital subtraction angiography in the evaluation in patients with cerebrovascular disease in Fein JM Flamm ES (eds): Cerebrovascular Surgery. New York: Springer-Verlag 1985 Vol 2 pp 343–358

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