title: Impact of pregnancy on the size of small cerebral aneurysm.
abstract: OBJECTIVE
  Because the management of cerebral aneurysms during pregnancy remains controversial, the objective of this study was to perform a retrospective review of pregnant women with cerebral aneurysms to determine whether pregnancy is a risk factor for aneurysm rupture.
  
  
  METHODS
  The change in size of aneurysms during pregnancy was examined by performing repeat magnetic resonance angiography in five pregnant women with cerebral aneurysms between 2005 and 2013. The outcome examined was development of subarachnoid hemorrhage.
  
  
  RESULTS
  Among the five pregnancies, there were eight cerebral aneurysms. Subarachnoid hemorrhage did not developed during any pregnancy. In four of the pregnancies, the cerebral aneurysms did not change in size during pregnancy, remaining 2-5 mm. Although in one pregnancy, the aneurysm increased from 6 to 7 mm during the third trimester, it returned to its original size in the postpartum period.
  
  
  CONCLUSIONS
  We suggest that if the cerebral aneurysm is small (≤ 5 mm), it is likely to remain unchanged despite the increase in circulating blood volume during pregnancy. Cerebral aneurysms greater than 5 mm but without blebs, irregular shape, high-risk location, or increased aspect ratio are also at low risk of rupture and are not likely to change during pregnancy.
authors.affiliation: a Department of Perinatology and Gynecology , National Cerebral and Cardiovascular Center , Osaka , Japan.|b Department of Obstetrics and Gynecology , Mie University School of Medicine , Mie , Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: a Department of Perinatology and Gynecology , National Cerebral and Cardiovascular Center , Osaka , Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Katsuragi
authors.affiliation: a Department of Perinatology and Gynecology , National Cerebral and Cardiovascular Center , Osaka , Japan.|b Department of Obstetrics and Gynecology , Mie University School of Medicine , Mie , Japan.
authors.forename: Kayo
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: a Department of Perinatology and Gynecology , National Cerebral and Cardiovascular Center , Osaka , Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Iwanaga
authors.affiliation: a Department of Perinatology and Gynecology , National Cerebral and Cardiovascular Center , Osaka , Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Yoshimatsu
authors.affiliation: c Department of Neurosugery , National Cerebral and Cardiovascular Center , Osaka , Japan.
authors.forename: Jun C
authors.initials: JC
authors.lastname: Takahashi
authors.affiliation: b Department of Obstetrics and Gynecology , Mie University School of Medicine , Mie , Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ikeda
mesh_terms: D000328:Adult; D017542:Aneurysm, Ruptured / Q000209:etiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D002532:Intracranial Aneurysm / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology / Q000473:pathology*; D011256:Pregnancy Outcome / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000209:etiology
keywords: Pregnancy; cerebral aneurysm; subarachnoid hemorrhage