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How Common Are Unruptured Brain Aneurysms in Adults? FREE

[+] Article and Author Information

The full report is titled “Prevalence of Unruptured Cerebral Aneurysms in Chinese Adults Aged 35 to 75 Years. A Cross-sectional Study.” It is in the 15 October 2013 issue of Annals of Internal Medicine (volume 159, pages 514-521). The authors are M.H. Li, S.W. Chen, Y.D. Li, Y.C. Chen, Y.S. Cheng, D.J. Hu, H.Q. Tan, Q. Wu, W. Wang, Z.K. Sun, X.E. Wei, J.Y. Zhang, R.H. Qiao, W.H. Zong, Y. Zhang, W. Lou, Z.Y. Chen, Y. Zhu, D.R. Peng, S.X. Ding, X.F. Xu, X.H. Hou, and W.P. Jia.


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Ann Intern Med. 2013;159(8):I-30. doi:10.7326/0003-4819-159-8-201310150-00001
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What is the problem and what is known about it so far?

A brain, or cerebral, aneurysm is a weak spot on a blood vessel in the brain that fills with blood and bulges. Brain aneurysms are common, affecting an estimated 1% to 5% of adults, but only a small percentage cause complications and rupture (around 1% annually). Large aneurysms can cause vision changes, pain, numbness, weakness, or paralysis on 1 side of the face. Aneurysms that burst (hemorrhage) can cause severe headaches, double vision, nausea, vomiting, neck stiffness, and loss of consciousness and can lead to stroke, damaged nerves, or death.

Because most aneurysms are not diagnosed until they cause symptoms, physicians would like a better idea of how many adults have undetected, unruptured brain aneurysms. If physicians could detect and identify aneurysms at risk for complications, they might be able to improve the management of these aneurysms and prevent ruptures.

Why did the researchers do this particular study?

To determine the prevalence of unruptured brain aneurysms in adults by using 3-dimensional time-of-flight magnetic resonance angiography (3D-TOF MRA), a noninvasive test that allows physicians to see blood flow in the brain and find problems with the blood vessels.

Who was studied?

4813 adults aged 35 to 75 years (2368 men and 2445 women; median age, 53 years) from 1 urban and 1 suburban community in Shanghai, China. Individuals were excluded if they had a pacemaker or metal implants or if they were no more than 3 months' pregnant.

How was the study done?

The participants had 3D-TOF MRA at a Shanghai hospital between June 2007 and June 2011. Three radiologists who were blinded to the participants’ information identified the location and size of any unruptured brain aneurysms and estimated their prevalence.

What did the researchers find?

During the procedure, 17 participants reported dizziness, but all completed the examination. Unruptured brain aneurysms were seen in 7.0% of the participants (5.5% of the men and 8.4% of the women). Almost all (90%) were less than one quarter of an inch in diameter, and most (81%) were located in the internal carotid artery, which supplies blood to the back part of the brain and the eyes and branches to the forehead and nose. Prevalence peaked between ages 55 and 64 years in both men and women.

What were the limitations of the study?

Participants were from 2 communities in Shanghai, and they may not be representative of adults in other areas. Adults older than 75 years were not studied.

What are the implications of the study?

Undetected, unruptured brain aneurysms may occur in approximately 7% of adults aged 35 to 75 years.

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