Department of Neurosurgery, University of Florida, Gainesville, Florida 32610, USA.
Neurosurgery. 2011 Jan;68(1):155-60; discussion 160-1. doi: 10.1227/NEU.0b013e3181ff357c.
The International Study of Intracranial Aneurysms found that for patients with no previous history of subarachnoid hemorrhage, small (< 7 mm) anterior circulation and posterior circulation aneurysms had a 0% and 2.5% risk of subarachnoid hemorrhage over 5 years, respectively.
To determine whether cerebral aneurysms shrink with rupture.
The clinical databases of 7 sites were screened for patients with imaging of cerebral aneurysms before and after rupture. Inclusion criteria included documented subarachnoid hemorrhage by imaging or lumbar puncture and intracranial imaging before and after cerebral aneurysm rupture. The patients were evaluated for aneurysm maximal height, maximal width, neck diameter, and other measurement parameters. Only a change of ≥ 2 mm was considered a true change.
Data on 13 patients who met inclusion criteria were collected. The median age was 60, and 11 of the 13 patients (84.6%) were female. Only 5 patients had posterior circulation aneurysms. None of the aneurysms had a significant decrease in size. One aneurysm decreased by 1.8 mm in maximum size after rupture (7.7%). Six aneurysms had an increase in maximum size of at least 2 mm after rupture (46.2%) with a mean increase of 3.5 mm (± 0.5 mm).
Unruptured aneurysms do not shrink when they rupture. The large percentage of ruptured small aneurysms in previous studies were likely small before they ruptured.
国际颅内动脉瘤研究发现，对于无蛛网膜下腔出血既往史的患者，小（<7mm）前循环和后循环动脉瘤分别有 0%和 2.5%的 5 年内蛛网膜下腔出血风险。
确定破裂的脑动脉瘤是否会缩小。
对 7 个地点的临床数据库进行筛选，寻找破裂前后有脑动脉瘤影像学的患者。纳入标准包括影像学或腰椎穿刺证实的蛛网膜下腔出血和脑动脉瘤破裂前后的颅内影像学。对患者的动脉瘤最大高度、最大宽度、颈部直径和其他测量参数进行评估。只有≥2mm 的变化才被认为是真正的变化。
共收集符合纳入标准的 13 例患者的数据。中位年龄为 60 岁，13 例患者中有 11 例（84.6%）为女性。仅有 5 例患者存在后循环动脉瘤。没有一个动脉瘤的大小有明显缩小。1 个动脉瘤在破裂后最大直径缩小了 1.8mm（7.7%）。6 个动脉瘤在破裂后最大直径至少增加了 2mm（46.2%），平均增加 3.5mm（±0.5mm）。
未破裂的动脉瘤在破裂时不会缩小。以前研究中较大比例的小破裂动脉瘤很可能在破裂前就很小。
