Natural history of unruptured intracranial aneurysms

Abstract

Therapeutic decisions regarding the management of patients with unruptured intracranial aneurysms ultimately involve consideration of the natural history of these lesions as well as the morbidity and mortality associated with their repair. Available evidence regarding the natural history of unruptured intracranial aneurysms suggests low overall rupture rates with relatively higher rates among patients with unruptured aneurysms and a history of subarachnoid hemorrhage from a separate aneurysm as opposed to patients with no history of subarachnoid hemorrhage. Among patients with no subarachnoid hemorrhage, aneurysmal size and location are independent predictors of future rupture. Among patients with prior subarachnoid hemorrhage, aneurysmal location independently predicts future rupture.