gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

A single-centre analysis of size and site of ruptured aneurysms: Is there an impact for the management of unruptured aneurysms?

Analyse der Größe und Lokalisation rupturierter Aneurysmen: Gibt es Auswirkungen auf das Management nicht-rupturierter Aneurysmen?

Meeting Abstract

  • corresponding author J. Liersch - Neurochirurgische Klinik, Heinrich-Heine Universität, Düsseldorf
  • D. Hänggi - Neurochirurgische Klinik, Heinrich-Heine Universität, Düsseldorf
  • B. Turowski - Radiologische Klinik, Abteilung für Neuroradiologie, Heinrich-Heine Universität, Düsseldorf
  • H.-J. Steiger - Neurochirurgische Klinik, Heinrich-Heine Universität, Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocP 059

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2007/07dgnc314.shtml

Published: April 11, 2007

© 2007 Liersch et al.
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Outline

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Objective: The International Study of Unruptured Intracranial Aneurysms (ISUIA) indicates that the aneurysm size and site play a significant role in determining the risk of future rupture. The lowest-risk natural history group includes asymptomatic patients with unruptured aneurysms less than 7mm in diameter in the anterior circulation. Nevertheless the management of this patient group is still controversial. For this reason we retrospectively analysed the size and site of ruptured aneurysms to compare the data with the common recommendation.

Methods: 163 patients with aneurysmal subarachnoid haemorrhage (SAH) admitted to our hospital between June 2003 to October 2006 were integrated in this retrospective analysis. Exact measurements of the size of ruptured aneurysms were taken from 3D-rotational angiography (3DRA) or computerised tomography angiography (CTA). The exclusion criteria were inadequate diagnostic quality for exact measurement as well as fusiform, mycotic and traumatic aneurysms. The categorisation of size was performed in accordance to the ISUIA classification.

Results: Overall 101 (62%) of 163 ruptured aneurysms measured less than 7mm in diameter. Out of a total of 134 anterior circulation aneurysms 82 ruptured aneurysms measured less than 7mm (61%) and out of these 41 (31%) measured less than 5 mm. Of the anterior circulation aneurysms, 33 aneurysms (25%) corresponded to the second ISUIA category (7 to 12mm), 16 (12%) to the third (13 to 24mm) and 3 (2%) to the fourth category (>25mm). Of the 29 posterior circulation aneurysms 18 aneurysms measured less than 7 mm, thereof 12 aneurysms less than 5 mm. 7 aneurysms corresponded to the second and 4 aneurysms to the third category.

Conclusions: This retrospective single centre analysis showed that the majority of ruptured aneurysms were of a size less than 7mm for the anterior and posterior circulation. Apart from size and site this result demonstrated the necessity for further parameters to be defined to determine the natural history of unruptured aneurysms.