Asian Journal of Neurosurgery

: 2019  |  Volume : 14  |  Issue : 2  |  Page : 422--426

Small aneurysms should be clipped?

Gustavo Noleto1, Nícollas Nunes Rabelo1, Leonardo Abaurre1, Hugo Sterman Neto1, Mario Siqueira1, Manoel J Teixeira2, Eberval Gadelha Figueiredo1 
1 Department of Neurosurgery, University of São Paulo Medical School, São Paulo, Brazil
2 Department of Neurosurgery, São Paulo University, São Paulo, Brazil

Correspondence Address:
Eberval Gadelha Figueiredo
Av. Dr. Enéas De Carvalho Aguiar, 255, Cerqueira César, São Paulo 01246-000

Background: Cerebral aneurysm prevalence may vary from 0.4% to 10%. The decision to treat or not incidental aneurysms remains controversial, especially when the lesions are small (<5 mm). Many recent publications are demonstrating that these lesions often bleed. Methods: We reviewed admitted patients with angiographic studies submitted to intracranial aneurysm surgical treatment from April 2012 to July 2013 in the Neurosurgery Department of São Paulo Medical School University (15 months), to define the rate and risk of bleeding. In addition, we proceeded literature review with collected 357 papers (past 5 years) which were selected 50 that were focused on our research. Clinical patients' status at the time of discharge was evaluated with the modified Rankin scale. Results: A series of 118 cases of surgically clipped aneurysms was analyzed: 73.7% woman; Ruptured (61 cases, 51%); middle cerebral artery (51 cases, 43%) was the more common aneurysm. Small size (<5 mm) was 25 cases (21%); that 2 died (16%), 3 (25%) with severe disability,restricted to bed and dependent on nursing care; blood pressure was the main risk factors (56%); and an aneurysm <2 mm (100%) was ruptured. Conclusion: The number of small aneurysms in our series was significant (25 cases, 21%), and its rate of bleeding was high (25 cases, 48%), resulting in death and disability in a significant number of cases. Our tendency is for surgical treatment when it is associated with risk factors.

How to cite this article:
Noleto G, Rabelo NN, Abaurre L, Neto HS, Siqueira M, Teixeira MJ, Figueiredo EG. Small aneurysms should be clipped?.Asian J Neurosurg 2019;14:422-426

How to cite this URL:
Noleto G, Rabelo NN, Abaurre L, Neto HS, Siqueira M, Teixeira MJ, Figueiredo EG. Small aneurysms should be clipped?. Asian J Neurosurg [serial online] 2019 [cited 2019 Sep 18 ];14:422-426
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