Skip to main content
Log in

Types of unruptured cerebral aneurysms reviewed from operation video-recordings

  • Clinical Articles
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

To estimate the proportion of unruptured cerebral aneurysms with thin-walled sac, we have analyzed the operative findings of 78 incidental cerebral aneurysms found in 51 consecutive surgical cases by reviewing of intra-operative videotape recordings. Among 78 unruptured aneurysms, 23 (30%) were evaluated as thick-walled aneurysms (Type A), 39 (50%) with partially thin-walled sac (Type B) and 16 (20%) with entirely thin wall sacs (Type C). The mean size of Type A aneurysms was 10.4 mm (ranging from 3 to 22 mm), in Type B it was 9.8 mm (ranging 4 to 25 mm) and in Type C it was 4.4 mm (between 2–12 mm). Approximately two-thirds of Type C aneurysms were 4 mm in size or smaller, and Type C aneurysms were significantly smaller than Type A aneurysms. In summary, this preliminary study has provided two original data. 1) About 70% of incidental unruptured aneurysms have a partially or entirely thin-walled sac. 2) Many of the small aneurysms have an entirely thin sac. Assuming that thin-walled aneurysms are at a high risk of subsequent rupture, the surgical intervention for incidental unruptured aneurysms may be recommended irrespective of their size if the surgical risk is considered low.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Crompton MR (1966) Mechanism of growth and rupture in cerebral berry aneurysms. BMJ 1: 1138–1142

    Google Scholar 

  2. Dell S (1982) Asymptomatic cerebral aneurysms: assessment of its risk of rupture. Neurosurgery 10: 162–166

    PubMed  Google Scholar 

  3. Heiskanen O (1981) Risk of bleeding from unruptured aneurysms in cases with multiple intracranial aneurysms. J Neurosurg 55: 524–526

    PubMed  Google Scholar 

  4. Jane JA, Kassell NF, Torner JC, Winn HR (1985) The natural history of aneurysms and AVMs. J Neurosurg 62: 321–323

    PubMed  Google Scholar 

  5. Juvela S, Porras M, Heiskanen O (1993) Natural history of unruptured intracranial aneurysms: a long-term follow-up study. J Neurosurg 79: 174–182

    PubMed  Google Scholar 

  6. Kassell NF, Torner JC (1983) Size of intracranial aneurysms. Neurosurgery 12: 291–297

    PubMed  Google Scholar 

  7. McCormick WF, Acosta-Rua GJ (1970) The size of intracranial saccular aneurysms: an autopsy study. J Neurosurg 33: 422–427

    PubMed  Google Scholar 

  8. Mizoi K, Kwak R, Sakamoto T, Suzuki J (1979) Angiographical study of intracranial saccular aneurysms: with particular reference to their size and shape. In: Suzuki J (ed) Cerebral aneurysms. Neuron C, Tokyo, pp 163–170

    Google Scholar 

  9. Mizoi K, Yoshimoto T, Nagamine Y, Kayama T, Koshu K (1995) How to treat incidental cerebral aneurysms: a review of 139 consecutive cases. Surg Neurol: in press

  10. Nakagawa T, Hashi K (1994) The incidence and treatment of asymptomatic, unruptured cerebral aneurysms. J Neurosurg 80: 217–223

    PubMed  Google Scholar 

  11. Piepgras DG (1988) Management of incidental intracranial aneurysms. Clin Neurosurg 35: 511–518

    Google Scholar 

  12. Schievink WI, Piepgras DG, Wirth FP (1992) Rupture of previously documented small asymptomatic saccular intracranial aneurysms. Report of three cases. J Neurosurg 76: 1019–1024

    PubMed  Google Scholar 

  13. Solomon RA, Correll JW (1988) Rupture of a previously documented asymptomatic aneurysm enhances the argument for prophylactic surgical intervention. Surg Neurol 30: 321–323

    PubMed  Google Scholar 

  14. Stehbens WE (1983) The pathology of intracranial arterial aneurysms and their complications. In: Fox JL (ed) Intracranial aneurysms, Vol 1. Springer, Berlin Heidelberg New York, pp 272–357

    Google Scholar 

  15. Stehbens WE (1983) Etiology and pathogenesis of intracranial berry aneurysms. In: Fox JL (ed) Intracranial aneurysms, Vol 1. Springer, Berlin Heidelberg New York, pp 358–395

    Google Scholar 

  16. Stehbens WE (1989) Etiology of intracranial berry aneurysms. J Neurosurg 70: 823–831

    PubMed  Google Scholar 

  17. van Crevel H, Habbema JDF, Braakman R (1986) Decision analysis of the management of incidental intracranial saccular aneurysms. Neurology 36: 1335–1339

    PubMed  Google Scholar 

  18. Wiebers DO, Whisnant JP, Sundt TM, O'Fallon WM (1987) The significance of unruptured intracranial saccular aneurysms. J Neurosurg 66: 23–29

    PubMed  Google Scholar 

  19. Winn HR, Almaani WS, Berga SL, Jane JA, Richardson AE (1983) The long-term outcome in patients with multiple aneurysms. Incidence of late hemorrhage and implications for treatment of incidental aneurysms. J Neurosurg 59: 642–651

    PubMed  Google Scholar 

  20. Wirth FP, Laws ER, Piepgras D, Scott RM (1983) Surgical treatment of incidental intracranial aneurysms. Neurosurgery 12: 507–511

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mizoi, K., Yoshimoto, T. & Nagamine, Y. Types of unruptured cerebral aneurysms reviewed from operation video-recordings. Acta neurochir 138, 965–969 (1996). https://doi.org/10.1007/BF01411286

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01411286

Keywords

Navigation