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Evergreen Notes

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Management of incidental unruptured intracranial aneurysm

Evergreen Notes Unruptured intracranial aneurysms (UIAs) affect 3% of the adult population in most Western countries and most do not rupture.

Management of incidental unruptured intracranial aneurysm

Evergreen Notes There is usually no benefit to invasive treatment or follow-up in elderly and frail patients with small aneurysms—they have better things to do.

Management of incidental unruptured intracranial aneurysm

Evergreen Notes In general, UIAs with a diameters > 5 mm in younger patients should be considered for treatment especially if irregular, enlarging and with a family history.

Management of incidental unruptured intracranial aneurysm

Evergreen Notes The risks associated with endovascular or neurosurgical treatment often exceed the natural history risk, especially with small UIAs.

Management of incidental unruptured intracranial aneurysm

Evergreen Notes The principal risk for rupture are size, location, smoking, hypertension and interval growth.

Management of incidental unruptured intracranial aneurysm

Evergreen Notes If the neurovascular multidisciplinary team does not consider UIA treatment to be beneficial, or if the patient declines it after a detailed discussion of risk and benefit, then conservative management should include treatment of vascular risk factors and non-invasive angiographic follow-up in selected cases.

Evergreen Notes