Choose your answer from aneurysm clipping, aneurysm coiling, catheter-based angiography, CT angiography, or serial magnetic resonance angiography.
A 31-year-old man with a 5-mm saccular aneurysm in the anterior communicating artery, found incidentally while investigating new-onset trigeminal neuralgia, is asymptomatic with normal physical and neurological examinations. The quiz explores the most appropriate management for this patient, considering various diagnostic and treatment options.
- Which of the following is the most appropriate management for a 31-year-old man with a 5-mm saccular aneurysm in the anterior communicating artery found incidentally?
- Aneurysm clipping
- Involves surgically cutting off blood flow to the aneurysm.
- Low risk of rupture and high risk of neurologic disability and morbidity.
- Aneurysm coiling
- A minimally invasive procedure using coils to promote blood clotting within the aneurysm.
- Similar to clipping
- Catheter-based angiography
- An invasive imaging technique used to visualize blood vessels.
- Used if further treatment is planned based on features predicting rupture.
- CT angiography
- Utilizes CT scans to visualize blood vessels.
- Unlikely to reveal a change in aneurysm size and carries risks from radiation and contrast medium.
- Serial magnetic resonance angiography
- Noninvasive imaging technique to track aneurysm growth.
- Monitors the aneurysm, as its at low risk for rupture.
Did You Know?
Risk for rupture at 5 years is low for unruptured intracranial arterial aneurysms less than 7 mm in the posterior circulation and less than 12 mm in the anterior circulation. Annual noninvasive imaging is recommended to track potential growth, a key predictor for rupture.