2016 Volume 25 Issue 1 Pages 4-14
Recent multicenter-prospective studies on unruptured intracranial aneurysms have demonstrated their annual and cumulative rupture rates in detail. These data have been mainly presented according to the location, size, and shape of the aneurysms. It is especially notable that the rupture rates in the Japanese population are significantly higher than those in the West.
In the clinical field especially, the therapeutic decision for unruptured aneurysms should be based on these up-to-date data to prevent their rupture. In addition, every neurosurgeon should consider the specific problems of each patient including their life expectancy, possible systemic diseases and health-related quality of life.
On the macroscopic point of view, a radical reduction in the number of domestic subarachnoid hemorrhage seems to be quite difficult to achieve when it is solely based on the conventional “Find and Treat” strategy. A simple simulation can show that this strategy requires an extremely large population to be screened to find medium- to large sized aneurysms which are prone to rupture. Only a novel paradigm of the therapeutic management of intracranial aneurysms will solve this problem in the future.
