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61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

Subsequent rupture of primary observed, small aneurysms of the anterior cerebral circulation – registry of patients

Meeting Abstract

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  • Nima Etminan - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf, Deutschland
  • Hans-Jakob Steiger - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf, Deutschland
  • Daniel Hänggi - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocP1832

DOI: 10.3205/10dgnc303, URN: urn:nbn:de:0183-10dgnc3037

Published: September 16, 2010

© 2010 Etminan et al.
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Outline

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Objective: According to results of the International Study of Unruptured Intracranial Aneurysms (ISUIA) the rupture risk of asymptomatic aneurysms smaller than 7mm in the anterior cerebral circulation is 0%.

Goal of the present study was to register patients with primary known asymptomatic aneurysms smaller than 7mm in the anterior circulation, who subsequently developed a subarachnoid hemorrhage (SAH) due to secondary rupture of the known aneurysm.

Methods: Patients met following criteria were included in the present single center register: 1) Diagnosis of an incidental and clinically asymptomatic cerebral aneurysm of the anterior cerebral circulation smaller than 7 mm, 2) No direct or indirect radiological features of hemorrhage documented by MRI and CT-scan 3) SAH in the follow-up period due to rupture of the primary known incidental aneurysm.

Results: From 2005–2009 a total number of four patients met the inclusion criteria. Patient #1 is a 79-year-old female, harboring a 5.8mm anterior communicating artery (ACOM) aneurysm, which ruptured 53 months after initial diagnosis. Patient #2 is a 66-year-old male with a right-sided 5.8 mm middle cerebral artery (MCA) aneurysm, which ruptured 6 months after first detection. Patient #3 is a 57-year-old male with a 4mm ACOM aneurysm and subsequent rupture 2 months after initial diagnosis. Patient #4 is a 31-year-old-male diagnosed with a 4 mm ACOM aneurysm, which ruptured 12 months after initial diagnosis.

Conclusions: The present data suggests that there is a risk of rupture with consecutive SAH of primary incidental aneurysms smaller than 7mm in the anterior circulation. As a consequence the introduction of a multicenter registry with retro-and prospectively collected data would be of great interest to gain additional data for risk analysis.