InFo Neurologie & Psychiatrie

, Volume 16, Issue 5, pp 50–55

Was tun beim Zufallsbefund?

Inzidentelle intrakranielle Aneurysmen
zertifizierte fortbildung

Zusammenfassung

Immer häufiger werden Aneurysmen intrakranieller Arterien per Zufall entdeckt. Das weitere Vorgehen ist eine interdisziplinäre Aufgabe und sollte wesentlich von der Abwägung der Risiken einer Subarachnoidalblutung gegenüber denen mikrochirurgischer oder endovaskulärer Interventionen bestimmt sein. Bei kleinen Aneurysmen und über 50-Jährigen spricht viel für ein konservatives Vorgehen.

Literatur

  1. 1.
    Vlak MHM, Algra A, Brandenburg R, Rinkel GJ. Prevalence of unruptured intracranial aneurysms with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis. Lancet Neurol 2011 (published online Jun 2, 2011).Google Scholar
  2. 2.
    Ruigrok YM, Buskens E, Rinkel GJ. Attributable risk of common and rare determinants of subarachnoid hemorrhage. Stroke 2001;32:1173–1175.PubMedCrossRefGoogle Scholar
  3. 3.
    Feigin V, Rinkel GJ, Lawes CMM, Algra A, Bennett DA, van Gijn J, Anderson CS. Risk factors for subarachnoid hemorrhage. An updated systematic review of epidemiological studies. Stroke 2005;36:2773–2780.PubMedCrossRefGoogle Scholar
  4. 4.
    Yasuno K, Bilguvar K, Bijlenga P, Low SK, Krischek B, Auburger G, Simon M, Krex D, Arlier Z, Nayak N, Ruigrok YM, Niemela M, Tajima A, von und zu Fraunberg M, Doczi T, Wirjatijasa F, Hata A, Blasco J, Oszvald A, Kasuya H, Zilani G, Schoch B, Singh P, Stüer C Risselada R, Beck J, Sola T, Ricciardi F, Aromaa A, Illig T, Schreiber S, van Duijn CM, van den Berg LH, Perret C, Proust C, Roder C, Ozturk AK, Gaál E, Berg D, Geisen C, Friedrich CM, Summers P, Frangi AF, State MW, Wichmann HE, Breteler MMB, Wijmenga C, Mane S, Peltonen L, Elio V, Sturkenboom MJJM, Lawford P, Byrne J, Macho J, Sandalcioglu EI, Meyer B, Raabe A, Steinmetz H, Rüfenacht D, Jääskeläinen JE, Hernesniemi J, Rinkel GJE, Zembutsu H, Inoue I, Palotie A, Cambien F, Nakamura Y, Lifton RP, Günel M. Genome-wide association study of intracranial aneurysm identifies three new risk loci. Nat Genet 2010;42:420–425.PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Korja M, Silventoinen K, McCarron P, Zdravkovic S, Skytthe A, Haapanen A, de Faire U, Pedersen NL, Christensen K, Koskenvuo M, J Kaprio, GenomEUtwin Project. Genetic epidemiology of spontaneous subarachnoid hemorrhage. Nordic Twin Study. Stroke 2010;41:2458–2462.PubMedCrossRefGoogle Scholar
  6. 6.
    Vlak MHM, Rinkel GJE, Greebe P, Algra A. Independent risk factors for intracranial aneurysms and their joint effect. A case-control study. Stroke 2013;44:984–987.PubMedCrossRefGoogle Scholar
  7. 7.
    Vlak MHM, Rinkel GJE, Greebe P, Greving JP, Algra A. Lifetime risks for aneurysmal subarachnoid haemorrhage: multivariable risk stratification. J Neurol Neurosurg Psychiat 2013;84:619–623.PubMedCrossRefGoogle Scholar
  8. 8.
    Feigin V, Lawes CMM, Bennett DA, Barker SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol 2009;8:355–369.PubMedCrossRefGoogle Scholar
  9. 9.
    Rinkel GJE, Algra A. Long-term outcomes of patients with aneurysmal subarachnoid haemorrhage. Lancet Neurol 2011;10:349–356.PubMedCrossRefGoogle Scholar
  10. 10.
    ISUIA - The International Study of Unruptured Intracranial Aneurysms Investigators. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet 2003;362:103–110.CrossRefGoogle Scholar
  11. 11.
    Juvela S, Poussa K, Lehto H, Porras M. Natural history of unruptured intracranial aneurysms. A Long-term follow-up study. Stroke 2013;44:2414–2421.PubMedCrossRefGoogle Scholar
  12. 12.
    Sonobe M, Yamazaki T, Yonekura M, Kikuchi H. Small unruptured intracranial aneurysm verification study - SUAVe Study Japan. Stroke 2010;41:1969–1977.PubMedCrossRefGoogle Scholar
  13. 13.
    Ishibashi T, Murayama Y, Urashima M, Saguchi T, Ebara M, Arakawa H, Irie K, Takao H, Abe T. Unruptured intracranial aneurysms: incidence of rupture and risk factors. Stroke 2009;40:313–316.PubMedCrossRefGoogle Scholar
  14. 14.
    Wermer MJ, van der Schaaf IC, Velthuis BK, Majoie CB, Albrecht KW, Rinkel GJ. Yield of short-term follow-up CT/MR angiography for small aneurysms detected at screening. Stroke 2006;37:414–418.PubMedCrossRefGoogle Scholar
  15. 15.
    UCAS - The UCAS Japan Investigators. The natural course of unruptured cerebral aneurysms in a Japanese cohort. N Engl J Med 2012;366:2474–2482.CrossRefGoogle Scholar
  16. 16.
    Güresir E, Vatter H, Schuss P, Platz J, Konczalla J, Du Mesnil de Rochemont R, Berkefeld J, Seifert V. Natural history of unruptured anterior circulation aneurysms. A prospective cohort study. Stroke 2013;44:3027–3031.PubMedCrossRefGoogle Scholar
  17. 17.
    Greving JP, Wermer MJH, Brown Jr RD, Morita A, Juvela S, Yonekura M, Ishibashi T, Torner JC, Nakayama T, Rinkel GJE, Algra A. Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies. Lancet Neurol 2014;13:59–66.PubMedCrossRefGoogle Scholar
  18. 18.
    Naggara ON, White PM, Guilbert F, Roy D, Weill A, Raymond J. Endovascular treatment if intracranial unruptured aneurysms: Systematic review and meta-analysis of the literature on safety and efficacy. Radiology 2010;256:887–897.PubMedCrossRefGoogle Scholar
  19. 19.
    Brinjikji W, Rabinstein AA, Lanzino G, Kallmes DF, Cloft HJ. Effect of age on outcomes of treatment of unruptured cerebral aneurysms. A study of the national inpatient sample 2001–2008. Stroke 2011;42:1320–1324.PubMedCrossRefGoogle Scholar
  20. 20.
    Ferns SP, Sprengers MES, van Rooij WJJ, van den Berg R, Velthuis BK, de Kort GAP, Sluzewski M, van Zwam WH, Rinkel GJE, Majoie CBLM. De novo aneurysm formation and growth of untreated aneurysms. A 5-year MRA follow-up in a large cohort of patients with coiled aneurysms and review of the literature. Stroke 2011;42:313–318.PubMedCrossRefGoogle Scholar
  21. 21.
    Rinkel GJ. Intracranial aneurysm screening: indications and advice for practice. Lancet Neurol 2005;4:122–128PubMedCrossRefGoogle Scholar

Copyright information

© Urban & Vogel 2014

Authors and Affiliations

  1. 1.Klinik für NeurologieZentrum der Neurologie und Neurochirurgie, Universitätsklinikum/Goethe-Universität FrankfurtFrankfurt am MainDeutschland

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