Introduction: The decision of to treat or not incidental aneurysms remains controversial, especially when the lesions are small. Although classical studies indicate a low rate of rupture in these aneurysms, there are many recent publications demonstrating that these lesions bleed with frequency.
Methods: We analysed the cases of intracranial aneurysms operated in a period of 15 months in our Department, in order to define the rate and risk of bleeding of these small aneurysms. Simultaneously we proceeded to a qualitative literature review on the subject focusing on articles published in the last 5 years.
Results: A series of 118 cases of surgically treated aneurysms (clipped) was analysed: 26.3% male and 73.7% female patients, with an average age of 54.1 years. Twenty five aneurysms were small and the incidence of rupture in this group was 48% (12 cases). Two of these patients died and 3 evolved with severe disability.
Conclusions: The number of small aneurysms in our series was significant (21%) and its rate of bleeding was high, resulting in death and disability in a significant number of cases. Our tendency is to operate these lesions, ruptured or not.
Patient Care: Understanding the natural history of aneurysms smaller than 5 mm may help patients with these vascular lesions, avoiding complications associated with these aneurysms
Learning Objectives: To describe the management for incidental cerebral aneurysms smaller than 5 mm
To describe the prognosis in subarachnoid hemorrhage associated with small aneurysms
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