Chen Peng Roc, Frerichs Kai, Spetzler Robert
Neurosurgery and Interventional Neuroradiology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Neurosurg Focus. 2004 Nov 15;17(5):E1. doi: 10.3171/foc.2004.17.5.1.
After an aneurysmal subarachnoid hemorrhage, nearly half of the patients die and the half who survive suffer from irreversible cerebral damage. With increasing use of noninvasive neuroimaging techniques (for example, magnetic resonance and computerized tomography angiography), more unruptured cerebral aneurysms are found. To understand the prevalence of unruptured aneurysms in the general population, along with the risks of aneurysm formation, data on growth and rupture rates are crucial. The risk of rupture in aneurysms smaller than 10 mm is still not quite clear without a population-based prospective study. Nevertheless, a 0.5 to 2% annual risk may be a reasonable estimate. Growing aneurysms and those larger than 10 mm carry a higher rate of rupture. The management of an unruptured intracranial aneurysm should be based on a thorough understanding of the natural history of these lesions and careful evaluation of the morbidity and mortality levels associated with each treatment option.
在动脉瘤性蛛网膜下腔出血后，近一半的患者死亡，而幸存的一半患者则遭受不可逆的脑损伤。随着非侵入性神经成像技术（例如，磁共振和计算机断层血管造影）的使用增加，发现了更多未破裂的脑动脉瘤。为了了解普通人群中未破裂动脉瘤的患病率以及动脉瘤形成的风险，关于生长和破裂率的数据至关重要。在没有基于人群的前瞻性研究的情况下，小于10毫米的动脉瘤破裂风险仍不太清楚。然而，每年0.5%至2%的风险可能是一个合理的估计。正在生长的动脉瘤以及大于10毫米的动脉瘤破裂率更高。未破裂颅内动脉瘤的治疗应基于对这些病变自然史的透彻了解以及对每种治疗选择相关的发病率和死亡率水平的仔细评估。
