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Intracranial aneurysms represent a major global health burden. Rupture of an intracranial aneurysm is a catastrophic event. Without access to treatment, the fatality rate is 50% in the first 30 days. Over the last three decades, treatment approaches for intracranial aneurysms have changed dramatically. There have been improvements in the medical management of aneurysmal subarachnoid haemorrhage, and there has been an evolution of treatment strategies. Endovascular therapy is now the mainstay of the treatment of ruptured intracranial aneurysms based on robust randomised controlled trial data. There is now an expansion of treatment indications for unruptured intracranial aneurysms to prevent rupture with both microsurgical clipping and endovascular treatment. Both microsurgical and endovascular treatment modalities have evolved, in particular with the introduction of innovative endovascular treatment options including flow diversion and intra-saccular flow disruption. These novel therapies allow clinicians to treat more complex and previously untreatable aneurysms. We aim to review the evolution of treatment strategies for intracranial aneurysms over time, and discuss emerging technologies that could further improve treatment safety and functional outcomes for patients with an intracranial aneurysm.
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http://dx.doi.org/10.3390/neurolint16010005 | DOI Listing |
Comput Biol Med
September 2025
INSIGNEO Institute for in silico medicine, University of Sheffield, UK; School of Mechanical, Aerospace and Civil Engineering, University of Sheffield, UK. Electronic address:
Modelling cardiovascular disease is at the forefront of efforts to use computational tools to assist in the analysis and forecasting of an individual's state of health. To build trust in such tools, it is crucial to understand how different approaches perform when applied to a nominally identical scenario, both singularly and across a population. To examine such differences, we have studied the flow in aneurysms located on the internal carotid artery and middle cerebral artery using the commercial solver Ansys CFX and the open-source code HemeLB.
View Article and Find Full Text PDFAJNR Am J Neuroradiol
September 2025
From the Department of Interventional Radiology (Shuailong Shi, Shuhai Long, Ji Ma, Peijie Lu, Jie Yang, Ye Wang, Tengfei Li), The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; The School of Life Science and Technology (Zhike Zhang), Xi'an Jiaotong University, Xi'an, China; an
Background And Purpose: Although high-resolution cone-beam computed tomography (HR-CBCT) is used for immediate evaluation of stent apposition, studies using this technique to evaluate flow diverter (FD) endothelialization during follow-up are limited. The study aims to investigate the potential of HR-CBCT in assessing FD endothelialization and identify factors influencing poor endothelialization.
Materials And Methods: The clinical and imaging data of patients with unruptured intracranial aneurysms (UIAs) treated by FDs from March 2019 to October 2023 were retrospectively analyzed.
Clin Neurol Neurosurg
September 2025
Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Center for Translational Neuro, & Behavioral Sciences (C-TNBS), University of Duisburg Essen, Germany.
Objective: Accurate prediction of the initial severity of aneurysmal subarachnoid hemorrhage (aSAH) is important for effective management of unruptured intracranial aneurysms (IA). This study aims to investigate patient and IA characteristics as pre-rupture predictors of severe aSAH.
Methods: This retrospective analysis included all patients aged 18 years or older diagnosed with acute aSAH at our center between January 2003 and June 2016.
Interv Neuroradiol
September 2025
Department of Neurological Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Lake Success, New York, USA.
BackgroundEndovascular coil embolization is a common treatment for intracranial aneurysms, but aneurysm recanalization remains a significant problem that may necessitate retreatment. This study aimed to identify patient, aneurysm, and procedural factors associated with recanalization in aneurysms treated exclusively with coil embolization.MethodsThis single center retrospective study assessed intracranial aneurysms treated with coiling-only between 2017 and 2022.
View Article and Find Full Text PDFNeurol Sci
September 2025
Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Background: Hereditary Hemorrhagic Telangiectasia (HHT) is an autosomal dominant disorder characterized by abnormal vascular formations across multiple organ systems, including the brain. While arteriovenous malformations (AVMs) are well recognized in HHT, non-AVM cerebrovascular malformations remain underreported and poorly understood manifestations of the disease.
Methods: A systematic review was conducted using multiple databases, applying a two-step screening process to exclude studies with insufficient, irrelevant, or incomplete data.