Unruptured Cerebral Aneurysms: Evaluation and Management.
Unruptured Cerebral Aneurysms: Evaluation and Management.
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DOI：
10.1155/2015/954954
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发表时间：
2015
影响因子：
--
通讯作者：
Bell R
中科院分区：
文献类型：
--
作者：
Ajiboye N;Chalouhi N;Starke RM;Zanaty M;Bell R
影像学技术的发展及其在临床实践中的应用增加，导致未破裂颅内动脉瘤的检出率更高。未破裂颅内动脉瘤的诊断是患者的一个重要压力来源，因为担心动脉瘤破裂，这与发病率和死亡率相当高有关。因此，重要的是，最佳管理的决定是在比较动脉瘤破裂的风险与干预相关的风险的基础上做出的。本综述根据文献中的现有证据，对未破裂颅内动脉瘤的流行病学、病理生理学、自然史、临床表现、诊断和治疗方案进行了全面概述。此外，作者还讨论了与颅内动脉瘤相关的遗传异常以及目前对有颅内动脉瘤家族史患者进行筛查的指南。由于在未破裂的颅内小动脉瘤的最佳管理方面存在重大争议，因此我们根据患者和动脉瘤特征以及干预的风险和受益提供了一种系统的管理方法。
The evolution of imaging techniques and their increased use in clinical practice have led to a higher detection rate of unruptured intracranial aneurysms. The diagnosis of an unruptured intracranial aneurysm is a source of significant stress to the patient because of the concerns for aneurysmal rupture, which is associated with substantial rates of morbidity and mortality. Therefore, it is important that decisions regarding optimum management are made based on the comparison of the risk of aneurysmal rupture with the risk associated with intervention. This review provides a comprehensive overview of the epidemiology, pathophysiology, natural history, clinical presentation, diagnosis, and management options for unruptured intracranial aneurysms based on the current evidence in the literature. Furthermore, the authors discuss the genetic abnormalities associated with intracranial aneurysm and current guidelines for screening in patients with a family history of intracranial aneurysms. Since there is significant controversy in the optimum management of small unruptured intracranial aneurysms, we provided a systematic approach to their management based on patient and aneurysm characteristics as well as the risks and benefits of intervention.