DOI: 10.3171/jns.2000.93.4.0550. Risk of rupture from incidental cerebral aneurysms

Risk of rupture from incidental cerebral aneurysms

10.3171/jns.2000.93.4.0550

Crossref journal-article

Journal of Neurosurgery Publishing Group (JNSPG)

Journal of Neurosurgery (1754)

Abstract

Object. Controversy still exists about the risk estimation for rupture of untreated saccular aneurysms presenting for causes other than subarachnoid hemorrhage (SAH). The object of this study was to address this issue.Methods. Between January 1976 and December 1997 in the Aizu Chuou Hospital, 62 patients underwent observation for more than 6 months for saccular, nonthrombotic, noncalcified unruptured aneurysms at locations not related to the cavernous sinus, which were detected in cerebral angiography studies performed for causes other than SAH. Clinical follow-up data in those 62 patients were reviewed to identify the risk of SAH.All patients were followed until July 1998, with the observation period ranging from 6 months to 17 years (mean 4.3 years). Seven patients (11.3%) developed SAH confirmed on computerized tomography (CT) scanning at a mean interval of 4.8 years, six of whom died and one of whom recovered with a major deficit. In addition, one patient died of the mass effect of the aneurysm, and another after sudden onset of headache and vomiting. The 5- and 10-year cumulative risks of CT-confirmed SAH calculated by the Kaplan—Meier method were 7.5% and 22.1%, respectively, for total cases, 33.5% and 55.9%, respectively, for large (> 10 mm) aneurysms, and 4.5% and 13.9%, respectively, for small (< 10 mm) aneurysms.Conclusions. Although based on a relatively small, single-institution series, our data indicated that the risk of rupture from incidental, intradural, saccular aneurysms was higher than previously reported, and may support preventive surgical treatment of incidental aneurysms, considering the fatality rate of SAH.

Bibliography

Tsutsumi, K., Ueki, K., Morita, A., & Kirino, T. (2000). Risk of rupture from incidental cerebral aneurysms. Journal of Neurosurgery, 93(4), 550â553.

Authors 4

Kazuo Tsutsumi (first)
Keisuke Ueki (additional)
Akio Morita (additional)
Takaaki Kirino (additional)

References 22 Referenced 115

10.1016/0090-3019(84)90120-4 / Surg Neurol / Neuroradiologic and neuropathologic findings with growing giant intracranial aneurysm. Review of the literature. by Artmann (1984)
{'key': 'b2', 'series-title': 'Surg Neurol', 'first-page': '227', 'article-title': 'The New England Journal of Medicine report on unruptured intracranial aneurysms: a critique.', 'volume': '51', 'author': 'Ausman', 'year': '1999'} / Surg Neurol / The New England Journal of Medicine report on unruptured intracranial aneurysms: a critique. by Ausman (1999)
10.1056/NEJM199905063401815 / N Engl J Med / Unruptured intracranial aneurysms. by Berenstein (1999)
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10.3171/jns.1981.55.4.0524 / J Neurosurg / Risk of bleeding from unruptured aneurysms in cases with multiple intracranial aneurysms. by Heiskanen (1981)
10.1016/0090-3019(91)90225-X / Surg Neurol / Follow-up study of unruptured aneurysms arising from the C3 and C4 segments of the internal carotid artery. by Inagawa (1991)
{'key': 'b8', 'series-title': 'N Engl J Med', 'first-page': '1725', 'article-title': 'Unruptured intracranial aneurysms—risk of rupture and risks of surgical intervention.', 'volume': '339', 'year': '1998'} / N Engl J Med / Unruptured intracranial aneurysms—risk of rupture and risks of surgical intervention. (1998)
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10.3171/jns.1993.79.2.0174 / J Neurosurg / Natural history of unruptured intracranial aneurysms: a long-term follow-up study. by Juvela (1993)
10.3171/jns.1994.81.6.0837 / J Neurosurg / Morbidity and mortality from elective surgery for asymptomatic, unruptured, intracranial aneurysms: a meta-analysis. by King (1994)
10.1161/01.STR.20.9.1150 / Stroke / Incidence and prognosis of subarachnoid hemorrhage in a Japanese rural community. by Kiyohara (1989)
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10.3171/jns.1966.25.3.0321 / J Neurosurg / Report on the Cooperative Study of Intracranial Aneurysms and Subarachnoid Hemorrhage. Section V. Part II. Natural history of subarachnoid hemorrhage, intracranial aneurysms and arteriovenous malformations. Based on 6368 cases in the Cooperative Study. by Locksley (1966)
{'key': 'b15', 'series-title': 'Clin Neurosurg', 'first-page': '511', 'article-title': 'Management of incidental intracranial aneurysms.', 'volume': '35', 'author': 'Piepgras', 'year': '1989'} / Clin Neurosurg / Management of incidental intracranial aneurysms. by Piepgras (1989)
{'key': 'b16', 'series-title': 'Surg Neurol', 'first-page': '361', 'article-title': 'Treatment of unruptured cerebral aneurysms.', 'volume': '51', 'author': 'Solomon', 'year': '1999'} / Surg Neurol / Treatment of unruptured cerebral aneurysms. by Solomon (1999)
10.3171/jns.1994.80.3.0440 / J Neurosurg / Surgical management of unruptured intracranial aneurysms. by Solomon (1994)
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10.1016/S0090-3019(96)00400-4 / Surg Neurol / Importance of management of unruptured cerebral aneurysms. by Yoshimoto (1997)

Dates

Type	When
Created	16 years, 3 months ago (May 13, 2009, 1:27 p.m.)
Deposited	2 years, 5 months ago (March 26, 2023, 6:31 p.m.)
Indexed	3 days, 21 hours ago (Aug. 23, 2025, 9:31 p.m.)
Issued	24 years, 10 months ago (Oct. 1, 2000)
Published	24 years, 10 months ago (Oct. 1, 2000)
Published Print	24 years, 10 months ago (Oct. 1, 2000)

Funders 0

None

BibTeX

@article{Tsutsumi_2000, title={Risk of rupture from incidental cerebral aneurysms}, volume={93}, ISSN={0022-3085}, url={http://dx.doi.org/10.3171/jns.2000.93.4.0550}, DOI={10.3171/jns.2000.93.4.0550}, number={4}, journal={Journal of Neurosurgery}, publisher={Journal of Neurosurgery Publishing Group (JNSPG)}, author={Tsutsumi, Kazuo and Ueki, Keisuke and Morita, Akio and Kirino, Takaaki}, year={2000}, month=oct, pages={550–553} }

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  "abstract": "<jats:p content-type=\"fine-print\"><jats:italic>Object.</jats:italic> Controversy still exists about the risk estimation for rupture of untreated saccular aneurysms presenting for causes other than subarachnoid hemorrhage (SAH). The object of this study was to address this issue.</jats:p><jats:p content-type=\"fine-print\"><jats:italic>Methods.</jats:italic> Between January 1976 and December 1997 in the Aizu Chuou Hospital, 62 patients underwent observation for more than 6 months for saccular, nonthrombotic, noncalcified unruptured aneurysms at locations not related to the cavernous sinus, which were detected in cerebral angiography studies performed for causes other than SAH. Clinical follow-up data in those 62 patients were reviewed to identify the risk of SAH.</jats:p><jats:p content-type=\"fine-print\">All patients were followed until July 1998, with the observation period ranging from 6 months to 17 years (mean 4.3 years). Seven patients (11.3%) developed SAH confirmed on computerized tomography (CT) scanning at a mean interval of 4.8 years, six of whom died and one of whom recovered with a major deficit. In addition, one patient died of the mass effect of the aneurysm, and another after sudden onset of headache and vomiting. The 5- and 10-year cumulative risks of CT-confirmed SAH calculated by the Kaplan\u2014Meier method were 7.5% and 22.1%, respectively, for total cases, 33.5% and 55.9%, respectively, for large (&gt; 10 mm) aneurysms, and 4.5% and 13.9%, respectively, for small (&lt; 10 mm) aneurysms.</jats:p><jats:p content-type=\"fine-print\"><jats:italic>Conclusions.</jats:italic> Although based on a relatively small, single-institution series, our data indicated that the risk of rupture from incidental, intradural, saccular aneurysms was higher than previously reported, and may support preventive surgical treatment of incidental aneurysms, considering the fatality rate of SAH.</jats:p>",
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