Risk of Rupture of Small Anterior Circulation Aneurysms: An Institutional Experience

Abstract

Abstract Great effort has been made in determining aneurysms at a higher risk of rupture because of risks associated both with their rupture and repair as well. The aim of this study was to determine the most common size of ruptured aneurysms in our patient population with ruptured intracranial aneurysms and to review the literature whether there is a critical size and a specific location at which the incidence of rupture of intracranial aneurysm increases. A retrospective analysis of patients with ruptured intracranial aneurysms admitted in a tertiary care hospital in Northern India between January 2011 and December 2014 was done, and size and location of all ruptured aneurysms were recorded. We stratified the incidence of hemorrhage across the following aneurysm size categories: small (10 mm or less), medium (10–15 mm), large (15–25 mm), and giant (> 25 mm). Our review included 265 patients with ruptured intracranial aneurysms in which 324 aneurysms were identified. In this series, 87.10% (231/265) of the patients had ruptured aneurysms sized less than 10 mm, and 190 out of 265 patients (71.6%) had ruptured aneurysms which were less than 7 mm. Most ruptured aneurysms were found on the anterior communicating artery (39.6%). Our study suggested that we need to recommend surgical treatment for even small unruptured aneurysms with irregular shape, especially anterior circulation aneurysms. Most intracranial aneurysms that are located at the anterior communicating artery and middle cerebral artery bifurcation are small and have high chances of rupture and should be considered for treatment.

Keywords

• subarachnoid hemorrhage
• aneurysm
• unruptured