Is the growth of cerebral aneurysms predictable?

ELAPSS score for prediction of risk of growth of unruptured intracranial aneurysms

Backes D, Rinkel GJE, Greving JP, et al.

Neurology 2017; 88:1600-1606.

Abstract

OBJECTIVE:

To develop a risk score that estimates 3-year and 5-year absolute risks for aneurysm growth.

METHODS:

From 10 cohorts of patients with unruptured intracranial aneurysms and follow-up imaging, we pooled individual data on sex, population, age, hypertension, history of subarachnoid hemorrhage, and aneurysm location, size, aspect ratio, and shape but not on smoking during follow-up and family history of intracranial aneurysms in 1,507 patients with 1,909 unruptured intracranial aneurysms and used aneurysm growth as outcome. With aneurysm-based multivariable Cox regression analysis, we determined predictors for aneurysm growth, which were presented as a risk score to calculate 3-year and 5-year risks for aneurysm growth by risk factor status.

RESULTS:

Aneurysm growth occurred in 257 patients (17%) and 267 aneurysms (14%) during 5,782 patient-years of follow-up. Predictors for aneurysm growth were earlier subarachnoid hemorrhage, location of the aneurysm, age >60 years, population, size of the aneurysm, and shape of the aneurysm (ELAPSS). The 3-year growth risk ranged from <5% to >42% and the 5-year growth risk from <9% to >60%, depending on the risk factor status.

CONCLUSIONS:

The ELAPSS score consists of 6 easily retrievable predictors and can help physicians in decision making on the need for and timing of follow-up imaging in patients with unruptured intracranial aneurysms.

 

This abstract is cited in the Neurochecklist:

Cerebral aneurysms: risk factors for rupture

Abstract link

Aneurysm with a surgical clip across the the neck or base. UMHealth System on Flikr. https://www.flickr.com/photos/umhealthsystem/7341436528
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