Unruptured cerebral aneurysms: Controversies on population screening

作者:Delgado Lopez Pedro David; Castilla Diez Jose Manuel; Martin Velasco Vicente
来源:Neurocirugia, 2016, 27(5): 237-244.
DOI:10.1016/j.neucir.2015.12.001

摘要

The idea of population screening of unruptured intracranial aneurysms is interesting because, despite recent advances in surgical and endovascular treatment, the mortality related to aneurismal subarachnoid haemorrhage reaches 30%. Screening is justified whenever the morbidity and mortality of the treatment (markedly lower for unruptured compared to ruptured aneurysms) overcomes the inherent risk of harbouring a brain aneurysm. Although, at present, this balance does not seem to favour population-based screening, it is justified in certain sub-populations with an increased risk of rupture. In this review, an analysis is made of the requirements for implementing a screening program, when would it be justified, what is to be expected from treatment (in terms of effectiveness, morbidity and costs), and what medical-legal issues are relevant and to determine the usefulness of the program. A study protocol is proposed aimed at examining the usefulness of population screening for brain aneurysms by magnetic resonance angiography.

  • 出版日期2016-10

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