Annual rupture risk of growing unruptured cerebral aneurysms detected by magnetic resonance angiography

Clinical article

Takashi Inoue M.D., Ph.D. 1 , Hiroaki Shimizu M.D., Ph.D. 1 , Miki Fujimura M.D., Ph.D. 2 , Atsushi Saito M.D., Ph.D. 1 and Teiji Tominaga M.D., Ph.D. 3
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  • 1 Department of Neurosurgery, Kohnan Hospital;
  • 2 Department of Neurosurgery, Sendai Medical Center; and
  • 3 Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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Object

In this paper, the authors' goals were to clarify the characteristics of growing unruptured cerebral aneurysms detected by serial MR angiography and to establish the recommended follow-up interval.

Methods

A total of 1002 patients with 1325 unruptured cerebral aneurysms were retrospectively identified. These patients had undergone follow-up evaluation at least twice. Aneurysm growth was defined as an increase in maximum aneurysm diameter by 1.5 times or the appearance of a bleb.

Results

Aneurysm growth was observed in 18 patients during the period of this study (1.8%/person-year). The annual rupture risk after growth was 18.5%/person-year. The proportion of females among patients with growing aneurysms was significantly larger than those without growing aneurysms (p = 0.0281). The aneurysm wall was reddish, thin, and fragile on intraoperative findings. Frequent follow-up examination is recommended to detect aneurysm growth before rupture.

Conclusions

Despite the relatively short period, the annual rupture risk of growing unruptured cerebral aneurysms detected by MR angiography was not as low as previously reported. Surgical or endovascular treatment can be considered if aneurysm growth is detected during the follow-up period.

Abbreviations used in this paper:ACoA = anterior communicating artery; ICA = internal carotid artery; MCA = middle cerebral artery; MRA = magnetic resonance angiography; SAH = subarachnoid hemorrhage.

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Contributor Notes

Address correspondence to: Takashi Inoue, M.D., Department of Neurosurgery, Kohnan Hospital, 4-20-1 Nagamachiminami, Taihaku-ku, Sendai, Miyagi 982-8523, Japan. email: tainoue@kohnan-sendai.or.jp.

Please include this information when citing this paper: published online April 27, 2012; DOI: 10.3171/2012.4.JNS112225.

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