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小型偶然发现的颅内动脉瘤的管理

Management of Small Incidental Intracranial Aneurysms.

作者信息

Burkhardt Jan-Karl, Benet Arnau, Lawton Michael T

机构信息

Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.

Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.

出版信息

Neurosurg Clin N Am. 2017 Jul;28(3):389-396. doi: 10.1016/j.nec.2017.02.006.

Abstract

Advances in neuroimaging and its widespread use for screening have increased the diagnosis of unruptured intracranial aneurysms (UIAs), including small-sized UIAs. The clinical management of these small-sized UIAs requires a patient-specific judgment of the risk of aneurysm rupture, if not treated, versus the risk of complications from surgical or endovascular treatment. Experienced cerebrovascular teams recommend treating small UIAs in young patients or in patients with more than one aneurysm rupture risk factor who also have a reasonable life expectancy. However, individual overall assessment of risk is critical for patients with UIAs to decide the next steps of care.

摘要

神经影像学的进展及其在筛查中的广泛应用增加了未破裂颅内动脉瘤(UIA)的诊断率,包括小型UIA。对于这些小型UIA的临床管理,如果不进行治疗,需要根据患者具体情况判断动脉瘤破裂的风险与手术或血管内治疗并发症的风险。经验丰富的脑血管团队建议,对于年轻患者或有多个动脉瘤破裂风险因素且预期寿命合理的患者,应对小型UIA进行治疗。然而,对于UIA患者,个体风险的全面评估对于决定下一步治疗至关重要。

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