title: [Unruptured cerebral aneurysms: Controversies on population screening].
abstract: The idea of population screening of unruptured intracranial aneurysms is interesting because, despite recent advances in surgical and endovascular treatment, the mortality related to aneurismal subarachnoid haemorrhage reaches 30%. Screening is justified whenever the morbidity and mortality of the treatment (markedly lower for unruptured compared to ruptured aneurysms) overcomes the inherent risk of harbouring a brain aneurysm. Although, at present, this balance does not seem to favour population-based screening, it is justified in certain sub-populations with an increased risk of rupture. In this review, an analysis is made of the requirements for implementing a screening program, when would it be justified, what is to be expected from treatment (in terms of effectiveness, morbidity and costs), and what medical-legal issues are relevant and to determine the usefulness of the program. A study protocol is proposed aimed at examining the usefulness of population screening for brain aneurysms by magnetic resonance angiography.
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario de Burgos, Burgos, España. Electronic address: pedrodl@yahoo.com.
authors.forename: Pedro David
authors.initials: PD
authors.lastname: Delgado Lopez
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario de Burgos, Burgos, España.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Castilla Díez
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario de Burgos, Burgos, España.
authors.forename: Vicente
authors.initials: V
authors.lastname: Martín Velasco
mesh_terms: D017542:Aneurysm, Ruptured; D002533:Cerebral Angiography; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging*; D018810:Magnetic Resonance Angiography; D013345:Subarachnoid Hemorrhage; D016896:Treatment Outcome
keywords: Aneurisma cerebral; Cerebral aneurysm; Clipado; Clipping; Coiling; Cribado; Embolización; Hemorragia subaracnoidea; Prognosis; Pronóstico; Screening; Subarachnoid haemorrhage