title: Small Unruptured Intracranial Aneurysm (≤5 mm) Associated with Epilepsy: Report of 2 Cases and Literature Review.
abstract: BACKGROUND
  Owing to the continuing improvements in imaging technology, an increasing number of epileptogenic small (≤5 mm) unruptured intracranial aneurysms (sUIAs) are being diagnosed. However, these sUIAs have not been systematically described and reviewed until now.
  
  
  BACKGROUND
  We report 2 patients with sUIAs who initially presented with complex partial seizures. Scalp electroencephalography identified the seizure activity as arising from the mesial temporal/frontal areas, but conventional magnetic resonance imaging (MRI) was normal in both patients. The diagnosis of sUIA was achieved by cerebral angiography. One of the patients had idiopathic seizures and sustained a subarachnoid hemorrhage before the final diagnosis of sUIA. Both of the patients were treated by surgical clipping without resection of the adjacent discolored brain tissue, and the seizures were controlled after surgery. Furthermore, we thoroughly reviewed the relevant literature. We analyzed a total of 5 documented cases, including out 2 cases, and described the clinical characteristics, diagnosis, underlying mechanism, treatment, and prognosis of epileptogenic sUIA.
  
  
  CONCLUSIONS
  The seizures caused by sUIAs are most likely related to subclinical hemorrhages. Angiography may be helpful in identifying seizures associated with sUIA in patients with normal conventional MRI findings. For epileptogenic sUIA with normal preoperative MRI, clipping without damaging the surrounding brain tissue may be sufficient to resolve this complex issue.
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, Fujian, China.
authors.forename: Fuxin
authors.initials: F
authors.lastname: Lin
authors.affiliation: Department of Neurosurgery, The Fourth Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Wan
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, Fujian, China.
authors.forename: Dezhi
authors.initials: D
authors.lastname: Kang
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, Fujian, China. Electronic address: lyx99070@163.com.
authors.forename: Yuanxiang
authors.initials: Y
authors.lastname: Lin
mesh_terms: D000328:Adult; D015901:Angiography, Digital Subtraction; D000072226:Computed Tomography Angiography; D003399:Craniotomy; D004827:Epilepsy / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged
keywords: Clipping; Epilepsy; Unruptured intracranial aneurysm