title: [Intracerebral aneurysm--treatment options, informed consent, and legal aspects].
abstract: All medical subspecialties and, in particular, high-tech field neurosurgery are subject to continuous change in therapeutic concepts due to novel treatment options emerging through research and evolution in the field. Hence, the question arises if the patient's informed consent needs to be adjusted in the face of multiple therapeutic options with different configurations of risk/benefit relationships. In this paper we discuss different therapeutic scenarios with regard to ruptured intracerebral aneurysms (RIA) and unruptured intracerebral aneurysms (UIA), and we advise the medical doctor involved in the process. Indeed, experienced neurosurgeons and endovascular interventionalists are very familiar with the management of these scenarios; likewise, interns, residents, and otherwise affiliated physicians may be faced with these situations. In general, asymptomatic and mentally capacitated patients as well as legal guardians of minor patients and of mentally incapacitated patients with incidental aneurysms and more than one therapeutic option need to be accurately informed about the advantages and disadvantages of the treatment options available to them. In case of emergency or when treating a mentally disabled patient who is incapable of making a sound judgment and has no legal guardian, the attending doctor will have to choose the best possible treatment option.
authors.affiliation: Neurochirurgische Klinik, Universitätsspital Zürich, Universität Zürich, Schweiz. JanKarl.Burkhart@gmail.com
authors.forename: Jan-Karl
authors.initials: JK
authors.lastname: Burkhardt
authors.forename: Werner Friedrich
authors.initials: WF
authors.lastname: Burkhardt
authors.forename: Pascal Olivier
authors.initials: PO
authors.lastname: Zinn
authors.forename: Oliver
authors.initials: O
authors.lastname: Bozinov
authors.forename: Helmut
authors.initials: H
authors.lastname: Bertalanffy
mesh_terms: D017542:Aneurysm, Ruptured / Q000628:therapy*; D005858:Germany; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence*; D002532:Intracranial Aneurysm / Q000628:therapy*; D007872:Legal Guardians / Q000331:legislation & jurisprudence; D008318:Malpractice / Q000331:legislation & jurisprudence; D016743:Mental Competency / Q000331:legislation & jurisprudence; D009313:National Health Programs / Q000331:legislation & jurisprudence*; D010043:Outcome and Process Assessment, Health Care; D010353:Patient Education as Topic / Q000331:legislation & jurisprudence*; D011379:Prognosis; D018570:Risk Assessment