Introduction: Intracranial imaging has become more frequent over the last several years. As a result, there has been an increase in the number of incidental intracranial aneurysms (IAs), which would intuitively lead to an increase in the numbers of unruptured IAs treated. However, it is not known if this trend would lead to increased treatment of IAs in uncommon locations. We examined a ten-year period to determine if IAs in uncommon locations were treated more often in an era of increased incidental IA discovery.
Methods: The UT Southwestern Medical Center maintains an IRB-approved database containing patients with intracranial aneurysms. We examined all treated IAs, both ruptured and unruptured, during the period of 2000-2009.
Results: During the years 2000-2009, 2236 IAs were treated at UT Southwestern Medical Center. The annual number increased from 153 in 2000 to 262 in 2009. The average number of ruptured IAs, both anterior and posterior circulation, did not increase during the decade. However, the average number of unruptured lesions did increase, as expected. The proximal ICA aneurysm, AComA, MCA bifurcation, and PComA all increased in numbers. However, distal ACA, choroidal ICA, ICA biurcation, cavernous ICA and distal MCA lesions did not increase. The number of basilar apex aneurysms increased. However, all other treated posterior circulation lesions did not increase over the decade.
Conclusions: Increasing numbers of treated unruptured intracranial aneurysms supports the most commonly encountered intracranial aneurysms and did not lead to an increase in the treatment of more uncommon intracranial aneurysms.
Patient Care: Understanding the most common aneurysms that warrant treatment and what to expect in a busy practice will help neurosurgeons who do not experience large numbers of vascular an insight into patterns of occurrence and treatment.
Learning Objectives: By the conclusion of this session, participants should be able to:
1) Describe the importance of the most common locations of intracranial aneurysms.
2) Discuss, in small groups, the distribution of intracranial aneurysms in practice.