Intracranial saccular aneurysm enlargement determined using serial magnetic resonance angiography

Restricted access

Object. The goal of this study was to determine the frequency of enlargement of unruptured intracranial aneurysms by using serial magnetic resonance (MR) angiography and to investigate whether aneurysm characteristics and demographic factors predict changes in aneurysm size.

Methods. A retrospective review of MR angiograms obtained in 57 patients with 62 unruptured, untreated saccular aneurysms was performed. Fifty-five of the 57 patients had no history of subarachnoid hemorrhage. The means of three measurements of the maximum diameters of these lesions on MR source images defined the aneurysm size. The median follow-up period was 47 months (mean 50 months, range 17–90 months).

No aneurysm ruptured during the follow-up period. Four patients (7%) harbored aneurysms that had increased in size. No aneurysms smaller than 9 mm in diameter grew larger, whereas four (44%) of the nine aneurysms with initial diameters of 9 mm or larger increased in size. Factors that predicted aneurysm growth included the size of the lesion (p < 0.001) and the presence of multiple lobes (p = 0.021). The location of the aneurysm did not predict an increased risk of enlargement.

Conclusions. Patients with medium-sized or large aneurysms and patients harboring aneurysms with multiple lobes may be at increased risk for aneurysm growth and should be followed up with MR imaging if the aneurysm is left untreated.

Article Information

Contributor Notes

Address reprint requests to: John Huston, M.D., Department of Diagnostic Radiology, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905.

© AANS, except where prohibited by US copyright law.

Headings
References
  • 1.

    Allcock JMCanham PB: Angiographic study of the growth of intracranial aneurysms. J Neurosurg 45:6176211976Allcock JM Canham PB: Angiographic study of the growth of intracranial aneurysms. J Neurosurg 45:617–621 1976

    • Search Google Scholar
    • Export Citation
  • 2.

    Forbes GFox AJHuston J IIIet al: Interobserver variability in angiographic measurement and morphologic characterization of intracranial aneurysms: a report from the International Study of Unruptured Intracranial Aneurysms. AJNR 17:140714151996Forbes G Fox AJ Huston J III et al: Interobserver variability in angiographic measurement and morphologic characterization of intracranial aneurysms: a report from the International Study of Unruptured Intracranial Aneurysms. AJNR 17:1407–1415 1996

    • Search Google Scholar
    • Export Citation
  • 3.

    Graves E: Detailed Diagnoses and Procedures National Hospital Discharge Survey 1990. Hyattsville, MD: US Department of Health and Human Services1992Graves E: Detailed Diagnoses and Procedures National Hospital Discharge Survey 1990. Hyattsville MD: US Department of Health and Human Services 1992

    • Search Google Scholar
    • Export Citation
  • 4.

    Huston J IIITorres VEWiebers DOet al: Follow-up of intracranial aneurysms in autosomal dominant polycystic kidney disease by magnetic resonance angiography. J Am Soc Nephrol 7:213521411996Huston J III Torres VE Wiebers DO et al: Follow-up of intracranial aneurysms in autosomal dominant polycystic kidney disease by magnetic resonance angiography. J Am Soc Nephrol 7:2135–2141 1996

    • Search Google Scholar
    • Export Citation
  • 5.

    The International Study of Unruptured Intracranial Aneurysms Investigators: Unruptured intracranial aneurysms—risk of rupture and risks of surgical intervention. N Engl J Med 339:172517331998The International Study of Unruptured Intracranial Aneurysms Investigators: Unruptured intracranial aneurysms—risk of rupture and risks of surgical intervention. N Engl J Med 339:1725–1733 1998

    • Search Google Scholar
    • Export Citation
  • 6.

    Jakubowski JKendall B: Coincidental aneurysms with tumours of pituitary origin. J Neurol Neurosurg Psychiatry 41:9729741978Jakubowski J Kendall B: Coincidental aneurysms with tumours of pituitary origin. J Neurol Neurosurg Psychiatry 41:972–974 1978

    • Search Google Scholar
    • Export Citation
  • 7.

    Jellinger K: Pathology of intracerebral hemorrhage. Zentralbl Neurochir 38:29421997Jellinger K: Pathology of intracerebral hemorrhage. Zentralbl Neurochir 38:29–42 1997

    • Search Google Scholar
    • Export Citation
  • 8.

    Juvela SPorras MHeiskanen O: Natural history of unruptured intracranial aneurysms: a long-term follow-up study. J Neurosurg 79:1741821993Juvela S Porras M Heiskanen O: Natural history of unruptured intracranial aneurysms: a long-term follow-up study. J Neurosurg 79:174–182 1993

    • Search Google Scholar
    • Export Citation
  • 9.

    Menghini VVBrown RD JrSicks JDet al: Incidence and prevalence of intracranial aneurysms and hemorrhage in Olmsted County, Minnesota, 1965 to 1995. Neurology 51:4054111998Menghini VV Brown RD Jr Sicks JD et al: Incidence and prevalence of intracranial aneurysms and hemorrhage in Olmsted County Minnesota 1965 to 1995. Neurology 51:405–411 1998

    • Search Google Scholar
    • Export Citation
TrendMD
Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 192 192 80
Full Text Views 144 86 0
PDF Downloads 105 52 0
EPUB Downloads 0 0 0
PubMed
Google Scholar