An overview of intracranial aneurysms

Alexander Keedy, Alexander Keedy

Abstract

Intracranial aneurysms are relatively common, with a prevalence of approximately 4%. Unruptured aneurysms may cause symptoms mainly due to a mass effect, but the real danger is when an aneurysm ruptures, leading to a subarachnoid hemorrhage. Most aneurysms are asymptomatic and will not rupture, but they grow unpredictably and even small aneurysms carry a risk of rupture. Intracranial aneurysms are diagnosed and monitored with imaging including intra-arterial digital subtraction angiography, computed tomography angiography, magnetic resonance angiography, and recently transcranial Doppler ultrasonograpy has been proposed as a potential modality. Treatment options include observation, endovascular coiling, and surgical clipping. This paper will review the epidemiology, pathogenesis, clinical presentation, diagnosis, natural history, and management of unruptured saccular intracranial aneurysms.

Figures

Figure 1
Figure 1
The circle of Willis.
Figure 2
Figure 2
Bilobed aneurysm of the right middle cerebral artery measuring 4x5mm.
Figure 3
Figure 3
Computed tomography (CT) angiography of the same aneurysm depicted in Figure 2.
Figure 4
Figure 4
Magnetic resonance (MR) angiogram depicting normal cerebral vasculature

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