Management of Small Unruptured Intracranial Aneurysms: A Survey of Neuroradiologists

Abstract

The natural history of intracranial aneurysms is not well-understood. A large proportion of incidentally detected, unruptured aneurysms are small (<7 mm). The survey results show significant heterogeneity in practice even among neuroradiologists and underlies the need to standardize imaging practice. Further studies are needed to assess the optimal frequency and duration of surveillance imaging for unruptured intracranial aneurysms. The criteria used to measure aneurysms and define growth on imaging also need to be standardized.

A functional polymorphism in the promoter region of miR‐155 predicts the risk of intracranial hemorrhage caused by rupture intracranial aneurysm

“…About 2% to 3% of the general population carries an unruptured IA, whereas about 30% of the IA patients suffer from several aneurysms . With the increased application of noninvasive imaging, the detection rate of these IA has gradually increased.…”

“…About 2% to 3% of the general population carries an unruptured IA, whereas about 30% of the IA patients suffer from several aneurysms. [22][23][24][25] With the increased application of noninvasive imaging, the detection rate of these IA has gradually increased. Upon the diagnosis of an unruptured aneurysm, an evaluation will be carried out to assess the likelihood of aneurysm rupture.…”

Letter to the Editor Regarding “Prevalence of Intracranial Aneurysm in Patients with Aortopathy: A Systematic Review with Meta-Analyses”

“…[7][8][9] There is significant heterogeneity in clinical practice regarding imaging surveillance of UIAs. 10 Frequent imaging surveillance of small, incidentally-detected aneurysms indefinitely using magnetic resonance angiography does not result in better health outcomes, given the costs and complications associated with aneurysm ablation. 8 Computed tomography angiography (CTA) is widely available, cheaper and has high spatial resolution, but it carries concerns of radiation exposure on prolonged surveillance.…”

Letter to the Editor Regarding “Preoperative Digital Subtraction Angiography in Incidental Unruptured Intracranial Aneurysms”

“…The guidelines do not specify the frequency and duration of imaging followup [3]. There is also significant heterogeneity in practice re- garding the modality for surveillance imaging, the criteria used for growth and criteria used for treatment of UIAs [4]. Routine imaging surveillance may not be cost-effective or add benefits in the case of small and very small aneurysms [5].…”