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Intracranial aneurysms are common, with a prevalence of 3% in the general population.1 The growing availability of brain imaging has increased the number of incidentally discovered aneurysms. Rupture of intracranial aneurysms and the resulting subarachnoid hemorrhage (SAH) has a high case fatality and morbidity, and occurs at a relatively young age compared with other types of stroke.2 As yet, we do not have a medical treatment to prevent intracranial aneurysm formation and its subsequent rupture. Our only preventive treatments for existing aneurysms consist of invasive surgery or endovascular treatment, each with inherent risk of complications including death or permanent disability.3 The risks of treatment have to be balanced carefully against the risk of rupture.4 Consequently, an important recent focus of aneurysm research has been the identification of risk factors of aneurysmal rupture. Recently, a meta-analysis of 6 prospective cohort studies showed that prognostic factors for aneurysm rupture include age, hypertension, history of SAH, aneurysm size, aneurysm location, and Finnish or Japanese descent.5 Other factors might also predict aneurysm rupture, including smoking6 and family history of SAH.7
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- © 2015 American Academy of Neurology
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