intracranial aneurysm

Introduction

Includes:

• brain aneurysm
  • cerebellar aneurysm
  • brainstem aneurysm
  • cerebral aneurysm

* see cerebral aneurysm

Laboratory

• higher genetically predicted serum magnesium associated with reduced risk of intracranial aneurysm & associated hemorrhage

Radiology

• catheter-based angiography necessary for definitive diagnosis
• imaging every 5 years for tiny (<= 3 mm) aneurysms

Complications

• rupture (5 year rupture rate)
  • anterior circulation
    • internal carotid artery, middle cerebral artery, anterior communicating artery
    • < 7 mm (0%)
    • 7-12 mm (2.6%)
    • 13-24 mm (14.5%)
    • > 25 mm (40%)
  • posterior circulation
    • basilar artery, posterior communicating artery
    • < 7 mm (2.5%)
    • 7-12 mm (14.5%)
    • 13-24 mm (18.4%)
    • > 25 mm (50%)

* ref reports annual rupture rates of

• 0% for aneurysms <= 3 mm
• 0.5% for aneurysms <= 5 mm
• <1% for aneurysms <= 7 mm

* pooled clinical complication risk of repai = 5%

Management

• neurosurgery for symptomatic enlarging aneurysms
• smoking cessation to reduce risk of aneurysm rupture
• for tiny aneurysms (<= 3 mm), no follow-up is the best strategy & is associated with the highest number of quality-adjusted life-years

More general terms

• vascular aneurysm

More specific terms

• brain aneurysm