[Natural history of unruptured cerebral aneurysms of the unoperated and observed cases].
OBJECTIVE
Natural history of unruptured cerebral aneurysms is still a matter of discussion. In this study, we investigated the prognosis of unruptured cerebral aneurysms of unoperated cases in a prospective design.


METHODS
Between September, 1992 and December, 2001, we have encountered a 256 cases of unruptured cerebral aneurysms. Among them, 118 cases were observed and were checked every year for their status. The endpoint was designed as their death and aneurysm rupture. Their rupture rate, mortality due to aneurysm death, and the cause of death other than aneurysm were investigated. Univariate analysis, chi-square test was used as statistics. A p-value less than 0.05 was considered as significant.


RESULTS
Annual rupture rate of unoperated unruptured cerebral aneurysms of size below 5 mm, between 5-15 mm, and over 15 mm increased according to the aneurysm size, 0.4%, 3.3% and 9.9% respectively. The sole risk factor for the feasibility of rupture of unruptured aneurysms was their size (p < 0.001). Aneurysm related mortality, however, was high in posterior circulation aneurysms. In patients under 70 years of age, 45% of patients died of cerebral aneurysms, but this rate decreased to 17% for patients over 70 years of age.


CONCLUSIONS
The rupture rate of unruptured cerebral aneurysms over 5 mm in size is not low. Unruptured aneurysms of the posterior circulation may have a much higher risk of rupture, so further investigation is necessary.
Matsumoto
Katsumi M
KM
Department of Neurosurgery, Stroke Center, Iseikai Hospital, Osaka City, Osaka, Japan.
Oota
Shinsuke
S
Aoki
Masanori
M
Yoshida
Junko
J
Taguchi
Kaoru
K
Sakaki
Saburo
S
Abekura
Makoto
M
Yoshimine
Toshiki
T
D000367:Age Factors; D000368:Aged; D017542:Aneurysm, Ruptured / Q000401:mortality* / Q000473:pathology; D002423:Cause of Death; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000401:mortality / Q000473:pathology; D015996:Survival Rate