UIA Unruptured aneurysms

Question 1

RF for ruptures UIA

Answer 1

1- patient factor ➡️Hx aSAH , multiple aneurysm, HTN , smoking 🚬,northern American 🇺🇸 < Europe < 🇯🇵 < Finland 🇫🇮, female > male , fHX ⬆️ 17 x ,
2 - aneurysm characteristics➡️
size ;;
< 5mm = 0.5%/ y
< 7mm = 0.4%/y
5-10 mm = 1.2%/y
> 10 mm = 1.5 %
>12 mm= 3.9%/y
> 15 mm = 6%/y

> 25 mm giant a = 8-50%/y
Morphology ➡️ daughter sac, bottleneck shape,⬆️ ratio of aneurysm size to parent vessels
📍➡️ PCOM and posterior circulation

Question 2

PHASES ➡️ scoring system 11estimates 5-year rupture risk

Answer 2

Question 3

Tx indication depend on UIATS unruptured intracranial aneurysm treatment score

Answer 3

1 - large + sx ➡️ intervention
2- patient < 60 ;
Size if < 7 mm + anterior circulation + 🚫 RF ➡️ medical
If < 7 mm + PCOM/ posterior circulation + sx+ FHX ➡️ intervention

3- patient. > 60 size
< 7 mm 🚫 FHX , 🚫 sx ➡️ medical
< 7 mm RF ➡️ intervention
7-12 mm anterior circulation medical vs intervention
7-12 mm PCOM / posterior circulation ➡️ intervention
> 12 mm ➡️ intervention

Question 4

F/ u for UIA un treated

Answer 4

MRA / CTA annual

Question 5

RF for growth of UIA

Answer 5

Size , locatiom( MCA,BA) , > 1 anurysum,FHX , 🚬