Abstract
Management of unruptured asymptomatic cerebral aneurysms is one of the most highly controversial and most discussed topics in vascular neurosurgery. The increasing availability and use of imaging modalities, including computed tomography with and without angiography, magnetic resonance imaging, magnetic resonance angiography, and digital subtraction angiography, has resulted in an increased number of diagnosed unruptured aneurysms. This trend has led more patients to ask if their vascular lesion should be treated and if so when should such treatment be done. The current medical literature shows conflicting data regarding the natural history of unruptured cerebral aneurysms and the risks associated with their management. In 2003, the International Study of Unruptured Intracranial Aneurysms (ISUIA) (11) showed that aneurysms in the anterior circulation measuring <7 mm had a 5-year cumulative risk of rupture of 0% in patients with no history of subarachnoid hemorrhage and that aneurysms measuring 7e12 mm had a 5-year cumulative risk of 2.6%, making the risk associated with any treatment modality
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