Pediatric intracranial aneurysms——clinical characteristics and therapeutic strategies

Objective To assess the radiological characteristics and therapeutic strategies of intracranial aneurysms in children. Methods From our dedicated neurovascular databank of patients, we reviewed 23 consecutive children who had 24 intracranial aneurysms. There were 14 boys and 9 girls with a mean age of 9.09 years ( range 1 - 14 years ). Results Intracranial aneurysms in children ≤ 14 years constituted 1.3% of all intracranial aneurysms. Internal Carotid artery (ICA) and middle cerebral artery (MCA) were the most frequent sites for aneurysms. About 58.3% of the aneurysms were complex, including dissecting, pseudoaneurysm, giant and fusiform aneurysm. 1/3 of all aneurysms were located in posterior circulation. Only 1 case had multiple aneurysms in this case series. Almost half of all cases presented with subarachnoid hemorrhage and others presented with mass effect. 14 cases underwent endovascular treatment. 4 patients received microsurgical therapy. 5 cases did not receive microsurgical or endovascular therapy, 2 of them whose aneurysms spontaneously thrombosed during follow up. One boy with left vertebral artery giant aneurysm died after endovascular therapy owing to gradual thrombosis in basilar artery. Another child had poor outcome because of rerupture of aneurysm before operation. Whereas the majority had a favorable outcome. Conclusions Intracranial aneurysms in children had many clinical and radiological characteristics different from those in adults : ( 1 ) remarkable male predominance; ( 2 ) ICA and MCA were the most common sites for aneurysms; (3) high incidence of large, traumatic, infectious, dissecting and fusiform aneurysms. (4)For pediatric intracranial aneurysms, both microsurgical approaches and endovascular treatment were effective. Endovaacular therapy was the best choice for complex aneurysms.     

Pediatric intracranial aneurysms——clinical characteristics and therapeutic strategies

Objective To assess the radiological characteristics and therapeutic strategies of intracranial aneurysms in children. Methods From our dedicated neurovascular databank of patients, we reviewed 23 consecutive children who had 24 intracranial aneurysms. There were 14 boys and 9 girls with a mean age of 9.09 years ( range 1 - 14 years ). Results Intracranial aneurysms in children ≤ 14 years constituted 1.3% of all intracranial aneurysms. Internal Carotid artery (ICA) and middle cerebral artery (MCA) were the most frequent sites for aneurysms. About 58.3% of the aneurysms were complex, including dissecting, pseudoaneurysm, giant and fusiform aneurysm. 1/3 of all aneurysms were located in posterior circulation. Only 1 case had multiple aneurysms in this case series. Almost half of all cases presented with subarachnoid hemorrhage and others presented with mass effect. 14 cases underwent endovascular treatment. 4 patients received microsurgical therapy. 5 cases did not receive microsurgical or endovascular therapy, 2 of them whose aneurysms spontaneously thrombosed during follow up. One boy with left vertebral artery giant aneurysm died after endovascular therapy owing to gradual thrombosis in basilar artery. Another child had poor outcome because of rerupture of aneurysm before operation. Whereas the majority had a favorable outcome. Conclusions Intracranial aneurysms in children had many clinical and radiological characteristics different from those in adults : ( 1 ) remarkable male predominance; ( 2 ) ICA and MCA were the most common sites for aneurysms; (3) high incidence of large, traumatic, infectious, dissecting and fusiform aneurysms. (4)For pediatric intracranial aneurysms, both microsurgical approaches and endovascular treatment were effective. Endovaacular therapy was the best choice for complex aneurysms.     

Pediatric intracranial aneurysms——clinical characteristics and therapeutic strategies

Objective To assess the radiological characteristics and therapeutic strategies of intracranial aneurysms in children. Methods From our dedicated neurovascular databank of patients, we reviewed 23 consecutive children who had 24 intracranial aneurysms. There were 14 boys and 9 girls with a mean age of 9.09 years ( range 1 - 14 years ). Results Intracranial aneurysms in children ≤ 14 years constituted 1.3% of all intracranial aneurysms. Internal Carotid artery (ICA) and middle cerebral artery (MCA) were the most frequent sites for aneurysms. About 58.3% of the aneurysms were complex, including dissecting, pseudoaneurysm, giant and fusiform aneurysm. 1/3 of all aneurysms were located in posterior circulation. Only 1 case had multiple aneurysms in this case series. Almost half of all cases presented with subarachnoid hemorrhage and others presented with mass effect. 14 cases underwent endovascular treatment. 4 patients received microsurgical therapy. 5 cases did not receive microsurgical or endovascular therapy, 2 of them whose aneurysms spontaneously thrombosed during follow up. One boy with left vertebral artery giant aneurysm died after endovascular therapy owing to gradual thrombosis in basilar artery. Another child had poor outcome because of rerupture of aneurysm before operation. Whereas the majority had a favorable outcome. Conclusions Intracranial aneurysms in children had many clinical and radiological characteristics different from those in adults : ( 1 ) remarkable male predominance; ( 2 ) ICA and MCA were the most common sites for aneurysms; (3) high incidence of large, traumatic, infectious, dissecting and fusiform aneurysms. (4)For pediatric intracranial aneurysms, both microsurgical approaches and endovascular treatment were effective. Endovaacular therapy was the best choice for complex aneurysms.     

Pediatric intracranial aneurysms——clinical characteristics and therapeutic strategies

Objective To assess the radiological characteristics and therapeutic strategies of intracranial aneurysms in children. Methods From our dedicated neurovascular databank of patients, we reviewed 23 consecutive children who had 24 intracranial aneurysms. There were 14 boys and 9 girls with a mean age of 9.09 years ( range 1 - 14 years ). Results Intracranial aneurysms in children ≤ 14 years constituted 1.3% of all intracranial aneurysms. Internal Carotid artery (ICA) and middle cerebral artery (MCA) were the most frequent sites for aneurysms. About 58.3% of the aneurysms were complex, including dissecting, pseudoaneurysm, giant and fusiform aneurysm. 1/3 of all aneurysms were located in posterior circulation. Only 1 case had multiple aneurysms in this case series. Almost half of all cases presented with subarachnoid hemorrhage and others presented with mass effect. 14 cases underwent endovascular treatment. 4 patients received microsurgical therapy. 5 cases did not receive microsurgical or endovascular therapy, 2 of them whose aneurysms spontaneously thrombosed during follow up. One boy with left vertebral artery giant aneurysm died after endovascular therapy owing to gradual thrombosis in basilar artery. Another child had poor outcome because of rerupture of aneurysm before operation. Whereas the majority had a favorable outcome. Conclusions Intracranial aneurysms in children had many clinical and radiological characteristics different from those in adults : ( 1 ) remarkable male predominance; ( 2 ) ICA and MCA were the most common sites for aneurysms; (3) high incidence of large, traumatic, infectious, dissecting and fusiform aneurysms. (4)For pediatric intracranial aneurysms, both microsurgical approaches and endovascular treatment were effective. Endovaacular therapy was the best choice for complex aneurysms.     

Pediatric intracranial aneurysms——clinical characteristics and therapeutic strategies

Objective To assess the radiological characteristics and therapeutic strategies of intracranial aneurysms in children. Methods From our dedicated neurovascular databank of patients, we reviewed 23 consecutive children who had 24 intracranial aneurysms. There were 14 boys and 9 girls with a mean age of 9.09 years ( range 1 - 14 years ). Results Intracranial aneurysms in children ≤ 14 years constituted 1.3% of all intracranial aneurysms. Internal Carotid artery (ICA) and middle cerebral artery (MCA) were the most frequent sites for aneurysms. About 58.3% of the aneurysms were complex, including dissecting, pseudoaneurysm, giant and fusiform aneurysm. 1/3 of all aneurysms were located in posterior circulation. Only 1 case had multiple aneurysms in this case series. Almost half of all cases presented with subarachnoid hemorrhage and others presented with mass effect. 14 cases underwent endovascular treatment. 4 patients received microsurgical therapy. 5 cases did not receive microsurgical or endovascular therapy, 2 of them whose aneurysms spontaneously thrombosed during follow up. One boy with left vertebral artery giant aneurysm died after endovascular therapy owing to gradual thrombosis in basilar artery. Another child had poor outcome because of rerupture of aneurysm before operation. Whereas the majority had a favorable outcome. Conclusions Intracranial aneurysms in children had many clinical and radiological characteristics different from those in adults : ( 1 ) remarkable male predominance; ( 2 ) ICA and MCA were the most common sites for aneurysms; (3) high incidence of large, traumatic, infectious, dissecting and fusiform aneurysms. (4)For pediatric intracranial aneurysms, both microsurgical approaches and endovascular treatment were effective. Endovaacular therapy was the best choice for complex aneurysms.     

Pediatric intracranial aneurysms——clinical characteristics and therapeutic strategies

Objective To assess the radiological characteristics and therapeutic strategies of intracranial aneurysms in children. Methods From our dedicated neurovascular databank of patients, we reviewed 23 consecutive children who had 24 intracranial aneurysms. There were 14 boys and 9 girls with a mean age of 9.09 years ( range 1 - 14 years ). Results Intracranial aneurysms in children ≤ 14 years constituted 1.3% of all intracranial aneurysms. Internal Carotid artery (ICA) and middle cerebral artery (MCA) were the most frequent sites for aneurysms. About 58.3% of the aneurysms were complex, including dissecting, pseudoaneurysm, giant and fusiform aneurysm. 1/3 of all aneurysms were located in posterior circulation. Only 1 case had multiple aneurysms in this case series. Almost half of all cases presented with subarachnoid hemorrhage and others presented with mass effect. 14 cases underwent endovascular treatment. 4 patients received microsurgical therapy. 5 cases did not receive microsurgical or endovascular therapy, 2 of them whose aneurysms spontaneously thrombosed during follow up. One boy with left vertebral artery giant aneurysm died after endovascular therapy owing to gradual thrombosis in basilar artery. Another child had poor outcome because of rerupture of aneurysm before operation. Whereas the majority had a favorable outcome. Conclusions Intracranial aneurysms in children had many clinical and radiological characteristics different from those in adults : ( 1 ) remarkable male predominance; ( 2 ) ICA and MCA were the most common sites for aneurysms; (3) high incidence of large, traumatic, infectious, dissecting and fusiform aneurysms. (4)For pediatric intracranial aneurysms, both microsurgical approaches and endovascular treatment were effective. Endovaacular therapy was the best choice for complex aneurysms.     

Pediatric intracranial aneurysms——clinical characteristics and therapeutic strategies

Objective To assess the radiological characteristics and therapeutic strategies of intracranial aneurysms in children. Methods From our dedicated neurovascular databank of patients, we reviewed 23 consecutive children who had 24 intracranial aneurysms. There were 14 boys and 9 girls with a mean age of 9.09 years ( range 1 - 14 years ). Results Intracranial aneurysms in children ≤ 14 years constituted 1.3% of all intracranial aneurysms. Internal Carotid artery (ICA) and middle cerebral artery (MCA) were the most frequent sites for aneurysms. About 58.3% of the aneurysms were complex, including dissecting, pseudoaneurysm, giant and fusiform aneurysm. 1/3 of all aneurysms were located in posterior circulation. Only 1 case had multiple aneurysms in this case series. Almost half of all cases presented with subarachnoid hemorrhage and others presented with mass effect. 14 cases underwent endovascular treatment. 4 patients received microsurgical therapy. 5 cases did not receive microsurgical or endovascular therapy, 2 of them whose aneurysms spontaneously thrombosed during follow up. One boy with left vertebral artery giant aneurysm died after endovascular therapy owing to gradual thrombosis in basilar artery. Another child had poor outcome because of rerupture of aneurysm before operation. Whereas the majority had a favorable outcome. Conclusions Intracranial aneurysms in children had many clinical and radiological characteristics different from those in adults : ( 1 ) remarkable male predominance; ( 2 ) ICA and MCA were the most common sites for aneurysms; (3) high incidence of large, traumatic, infectious, dissecting and fusiform aneurysms. (4)For pediatric intracranial aneurysms, both microsurgical approaches and endovascular treatment were effective. Endovaacular therapy was the best choice for complex aneurysms.     

Pediatric intracranial aneurysms——clinical characteristics and therapeutic strategies

Objective To assess the radiological characteristics and therapeutic strategies of intracranial aneurysms in children. Methods From our dedicated neurovascular databank of patients, we reviewed 23 consecutive children who had 24 intracranial aneurysms. There were 14 boys and 9 girls with a mean age of 9.09 years ( range 1 - 14 years ). Results Intracranial aneurysms in children ≤ 14 years constituted 1.3% of all intracranial aneurysms. Internal Carotid artery (ICA) and middle cerebral artery (MCA) were the most frequent sites for aneurysms. About 58.3% of the aneurysms were complex, including dissecting, pseudoaneurysm, giant and fusiform aneurysm. 1/3 of all aneurysms were located in posterior circulation. Only 1 case had multiple aneurysms in this case series. Almost half of all cases presented with subarachnoid hemorrhage and others presented with mass effect. 14 cases underwent endovascular treatment. 4 patients received microsurgical therapy. 5 cases did not receive microsurgical or endovascular therapy, 2 of them whose aneurysms spontaneously thrombosed during follow up. One boy with left vertebral artery giant aneurysm died after endovascular therapy owing to gradual thrombosis in basilar artery. Another child had poor outcome because of rerupture of aneurysm before operation. Whereas the majority had a favorable outcome. Conclusions Intracranial aneurysms in children had many clinical and radiological characteristics different from those in adults : ( 1 ) remarkable male predominance; ( 2 ) ICA and MCA were the most common sites for aneurysms; (3) high incidence of large, traumatic, infectious, dissecting and fusiform aneurysms. (4)For pediatric intracranial aneurysms, both microsurgical approaches and endovascular treatment were effective. Endovaacular therapy was the best choice for complex aneurysms.     

Pediatric intracranial aneurysms——clinical characteristics and therapeutic strategies

Objective To assess the radiological characteristics and therapeutic strategies of intracranial aneurysms in children. Methods From our dedicated neurovascular databank of patients, we reviewed 23 consecutive children who had 24 intracranial aneurysms. There were 14 boys and 9 girls with a mean age of 9.09 years ( range 1 - 14 years ). Results Intracranial aneurysms in children ≤ 14 years constituted 1.3% of all intracranial aneurysms. Internal Carotid artery (ICA) and middle cerebral artery (MCA) were the most frequent sites for aneurysms. About 58.3% of the aneurysms were complex, including dissecting, pseudoaneurysm, giant and fusiform aneurysm. 1/3 of all aneurysms were located in posterior circulation. Only 1 case had multiple aneurysms in this case series. Almost half of all cases presented with subarachnoid hemorrhage and others presented with mass effect. 14 cases underwent endovascular treatment. 4 patients received microsurgical therapy. 5 cases did not receive microsurgical or endovascular therapy, 2 of them whose aneurysms spontaneously thrombosed during follow up. One boy with left vertebral artery giant aneurysm died after endovascular therapy owing to gradual thrombosis in basilar artery. Another child had poor outcome because of rerupture of aneurysm before operation. Whereas the majority had a favorable outcome. Conclusions Intracranial aneurysms in children had many clinical and radiological characteristics different from those in adults : ( 1 ) remarkable male predominance; ( 2 ) ICA and MCA were the most common sites for aneurysms; (3) high incidence of large, traumatic, infectious, dissecting and fusiform aneurysms. (4)For pediatric intracranial aneurysms, both microsurgical approaches and endovascular treatment were effective. Endovaacular therapy was the best choice for complex aneurysms.     

儿童颅内动脉瘤的临床特征及治疗

目的 探讨儿童颅内动脉瘤的发病特点、影像学特征及其治疗策略.方法 对宣武医院神经外科及神经介入中心1985年10月至2008年5月共23例14岁以下(含14岁)儿童的24个颅内动脉瘤的发病方式、部位、大小等影像学特点、治疗方式及其结果进行回顾性分析.结果 儿童颅内动脉瘤占所有年龄组颅内动脉瘤的1.3%,男:女=1.56:1;24个动脉瘤中,16个位于前循环,8个位于后循环;14个属于复杂动脉瘤;以蛛网膜下腔出血为表现者11例;14例采用神经介入治疗,4例采用显微手术治疗,5例未行外科治疗,其中2例在随访过程中动脉瘤及载瘤动脉自行闭塞而自愈;1例死亡,1例因术前动脉瘤再破裂导致中度致残,其余21例结果良好.结论 (1)儿童颅内动脉瘤较为罕见,发病率男性高于女性;(2)颈内动脉及大脑中动脉是儿童颅内动脉瘤的好发部位;(3)与成人相比,巨大动脉瘤、夹层动脉瘤及后循环动脉瘤、感染或外伤性动脉瘤比例较高;(4)神经介入及显微手术都是治疗儿童颅内动脉瘤的有效方法,但对于复杂动脉瘤首选神经介入治疗,相当一部分动脉瘤甚至不得不采用载瘤动脉闭塞的方法治疗.     

16层CTA与DSA诊断颅内动脉瘤效能的对比研究

目的 对比CTA与DSA诊断颅内动脉瘤的效能.方法 首都医科大学附属北京天坛医院神经外科自2007年7月至2008年7月连续收治疑动脉瘤患者82例,均行DSA与CTA检查,确诊为动脉瘤患者行手术治疗.比较DSA、CTA检查的阳性率和二者诊断动脉瘤的特异性、敏感性和准确性.比较CTA检查与术中测量瘤体、瘤颈直径的大小,观察CTA、DSA检查对不同部位、大小动脉瘤的显示情况.结果 CTA检出动脉瘤74个,DSA正确检出81个,二者阳性率差异无统计学意义(x2=1.897,P=0.163).以DSA检查结果为标准,CTA发现动脉瘤的灵敏性为91.4%(74/81),特异性为91.7%(11/12),准确性为91.4%(85/93);65例患者行手术治疗,术中发现动脉瘤73个,以手术结果为标准,CTA、DSA检查的灵敏性比较差异有统计学意义(P<0.05),特异性、准确性比较差异无统计学意义(P>0.05);与术中测量的瘤体、瘤颈直径比较,CTA检查结果较大,差异有统计学意义(P<0.05);CTA检查对不同部位、大小动脉瘤的灵敏度不同,而DSA检查具有较高敏感性.结论 16层CTA具有无创、快捷、敏感、高效等优点,可做为筛选动脉瘤的方法,部分患者可凭CTA指导手术.

Abstract：

Objective To assess the values of 16-slice CTA and DSA in the diagnosis of intracranial aneurysms. Methods Eighty-two patients with SAH,suspected having aneurysms and admitted to our hospital from July 2007 to July 2008,received DSA and CTA;the clinical data of these patients were analyzed;CTA images were compared blindly with the DSA findings,including the presence,location,and size of aneurysms.With SPSS 11.5 statistical software,the sensitivity,specificity and accuracy of CTA and DSA were compared. Results Eighty-one aneurysms were detected by DSA and 74 aneurysms by CTA;no significant difirences on the positive detected rate were noted(x2=1.897,P=0.163).The sensitivity of CTA for detection of all aneurysms versus that of DSA was 91.4%,the specificity of CTA 91.7%.and the accuracy of CTA 91.4%.Sixty-five patients underwent surgery (clipping)and 73 aneurysms were confirmed by this surgery;CTA had a sensitivity of 89.0%,specificity of 100%and accuracy of 90.5%:DSA had a sensitivity of 98.6%,specificity of 84.6%and accuracy of 98.8%;significant statistical diference on sensitivity (x2=5.625,P<0.05)and no significant statistical diference on specificity and accuracy (x2=1.846 and 2.450,respetively,P>0.05)were found between them.As compared with the sizes of aneurysms and the diameters of aneurysm necks measured during the operation,these results detected by CTA were significantly larger(P<0.05).CTA had different detection sensitivities to aneurysms at different locations and with different sizes,while DSA had high sensitivity.Conclusion CTA is a noninvasive, quick, sensitive and efficient tool to diagnose inrtacranial aneurysms.It can be specially used to screen aneurysms in SAH patients.In some cases,CTA can guide the surgery.     

35例颅内动脉瘤的手术体会

我科自2000年1月～2005年10月采用颅内动脉瘤夹闭术治疗颅内动脉瘤35例，现报告如下。 1对象与方法 男16例．女19例：年龄35～65岁，平均45．6岁。大脑前动脉瘤1例．前交通动脉瘤15例，后交通动脉瘤17例，大脑中动脉瘤2例。动脉瘤直径4．0～18．0mm。首发症状：蛛网膜下腔出血（SAH）29例、短暂性脑缺血发作（TIA）1例（大脑中动脉瘤），动眼神经麻痹5例。Hunt-Hess0级6例，Ⅰ级19例，Ⅱ级7例，Ⅲ级3例。手术时间：发病48h14例，3～10d3例，11～16d18例。手术方法：瘤颈夹闭32例．瘤颈夹闭加包裹术2例．大脑中动脉梭形动脉瘤1例行部分切除加夹闭术。术中动脉瘤破裂3例。     

显微外科手术治疗颅内动脉瘤25例

目的：总结25例颅内动脉瘤的显微外科手术治疗经验，探讨显微手术技巧及动脉瘤破裂的处理。方法：在气管插管全麻及控制性低血压下，依据动脉瘤的部位选择手术入路，在显微镜直视下操作，解剖动脉瘤颈，稳妥夹闭瘤蒂，结果：本组25例中术后恢复工作19例（76％），轻残3例，重残2例，死亡1例，并发脑积水2例，水灶性脑梗塞2例。结论：显微神经外科技术使颅内动脉瘤手术成功率明显提高，采用控制性低血压和暂时阻断载瘤动脉是降低术中动脉瘤破裂出血和术后病人致残及死亡的重要措施。脑积水是最常见并发症，需行V－P分流。     

动脉瘤破裂致蛛网膜下腔出血的早期手术治疗

1对象与方法我院自2004年1月～2005年7月对15例颅内动瘤施行早期动脉瘤夹闭术,其中男8例,女7例;年龄9～60岁,平均34.5岁.均以蛛网膜下腔出血(SAH)为首发症状.术前Hunt分级:Ⅰ级4例,Ⅱ级6例,Ⅲ级3例,Ⅳ级2例.其中合并癫癎5例,偏瘫4例,动眼神经麻痹3例.DSA检查示动脉瘤位于大脑中动脉瘤M1段5例,颈内动脉-后交通动脉4例,前交通动脉3例,颈内动脉3例.     

中小型颅内动脉瘤自发性闭塞(四例报告并文献复习)

目的 探讨蛛网膜下腔出血血管造影阴性病例动脉瘤自闭假说的起初真实性，以及导致动脉瘤自闭发生的相关因素。方法 回顾性分析临床上出现的经全脑血管造影证实的４例明确的动脉瘤症例动脉瘤自闭现象，对动脉瘤自闭发生的因素进行了分析。结论 在蛛网膜下腔出血全脑血管造影阴性时，要考虑到动脉瘤自闭的可能，不论是否巨大动脉瘤，均有发生自闭的可能。与动脉瘤自闭有关的因素有：血流速度的改变、动脉瘤的大小、形态、部位及动脉     

早期显微手术治疗颅内动脉瘤破裂(附216例分析)

目的探讨显微手术治疗破裂颅内动脉瘤的经验.方法总结216例Ⅰ～Ⅴ级颅内动脉瘤破裂病人的临床资料,包括动脉瘤的分级,手术时机的选择,脑保护剂与暂时阻断载瘤动脉联合应用,脑血管痉挛治疗,直接手术处理动脉瘤的技术等.结果术后早期良好191例,差12例,死亡13例.结论对颅内动脉瘤破裂早期采取显微手术与综合治疗措施,能有效改善病人的预后.     

颅内后循环复杂动脉瘤的诊治

目的探讨颅内后循环复杂动脉瘤的诊断及治疗。方法回顾分析38例颅内后循环复杂动脉瘤病人资料,Hunt-Hess分级0级5例,Ⅰ级10例,Ⅱ级19例,Ⅲ级3例,Ⅳ级1例;其中开颅手术3例,介入治疗25例,介入联合开颅治疗1例,未治疗9例。结果出院时根据GOS评分:4～5分20例,2～3分15例,死亡3例。17例经3个月～1.5年随访,其中GOS4～5分12例,2～3分2例,死亡3例。结论 DSA尤其3D-DSA是诊断颅内后循环动脉瘤的金标准,颅内后循环复杂动脉瘤多以介入治疗为主,其治疗应遵循个体化原则。     

中脑周围非动脉瘤性蛛网膜下腔出血

目的:提高对中脑周围蛛网膜下腔出血(PNSH)的认识水平。方法:回顾性分析17例PNSH病人的临床 表现、影像学表现、治疗及预后情况。结果:本组病例2d～6d内DSA检查均阴性,全部治愈出院,住院期间无并发症发 生。结论:PNSH是一种特殊类型的SAH,临床表现平稳,影像学检查独特,恢复期短,预后良好。     

未破裂颅内动脉瘤

国外对未破裂动脉瘤的关注较早，做了很多研究工作。但直到ISUIA（International Study of Unruptured Intracranial Aneurysms Investigators）1998年I期及2003年Ⅱ期研究结果的公布,给神经外科界带来不小的震动。对于未破裂动脉瘤的自然史及治疗方案的确定至今仍存在争论。