Document Detail


Unruptured intracranial aneurysms: benign curiosity or ticking bomb?
MedLine Citation:
PMID:  14747000     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
15 years ago, the treatment of incidentally discovered intracranial aneurysms was straightforward with a good evidence base behind it. When intracranial aneurysms were identified, people were referred to neurosurgeons who would offer surgical repair if the patient was in reasonable health and had a good life expectancy. Since that time, several studies have given contradictory evidence for what should be done with these lesions, and a new technique for the repair of aneurysms, endovascular coil embolisation, has been developed. Here we review the research and make several recommendations. First, incidentally discovered aneurysms in the anterior circulation less than 7 mm in size in people with no personal or family history of subarachnoid haemorrhage should be left untreated. Second, people with remaining life expectancy of less than 20 years or so (ie, those over age 60 years) should be informed that from a statistical point of view the benefits of treatment do not outweigh the risks. Third, in all other cases treatment with surgical clipping or coil embolisation should be advised. And finally, if surgical treatment is not feasible then medical hypotensive treatment may be a viable alternative.
Authors:
Patrick Mitchell; Anil Gholkar; Raghu R Vindlacheruvu; A David Mendelow
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Lancet. Neurology     Volume:  3     ISSN:  1474-4422     ISO Abbreviation:  Lancet Neurol     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-01-28     Completed Date:  2004-03-10     Revised Date:  2014-08-15    
Medline Journal Info:
Nlm Unique ID:  101139309     Medline TA:  Lancet Neurol     Country:  England    
Other Details:
Languages:  eng     Pagination:  85-92     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Diagnostic Imaging
Humans
Intracranial Aneurysm / complications,  diagnosis*,  therapy*
Mass Screening
Risk Factors
Subarachnoid Hemorrhage / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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