Attempting to Define Growth and Rupture Risk of Small Intracranial Aneurysms

With the widespread use of neuroimaging studies, more unruptured intracranial aneurysms are being identified, particularly small aneurysms that are incidentally discovered. Once an aneurysm is identified, this bell cannot be unrung, and a careful discussion of the risks of surveillance or treatment ensues. The stakes are high, because aneurysmal rupture can cause significant morbidity and mortality, treatment has associated procedural risks, and the optimal surveillance strategy is unknown. (American Heart Association/American Stroke Association guidelines, based on limited data and expert opinion, suggest that follow-up imaging at 6 to 12 months followed by imaging every year or two may be considered.)

Now, researchers have systematically r…