What is the role of imaging studies in the workup of cerebral aneurysms?

Updated: Dec 06, 2018
  • Author: David S Liebeskind, MD, FAAN, FAHA, FANA; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Advances in neuroimaging techniques have altered the diagnosis of cerebral aneurysms dramatically. Noninvasive angiographic methods, such as computed tomographic angiography (CTA) and magnetic resonance angiography (MRA), allow for detection and characterization of aneurysms, further enhanced by postprocessing techniques that enable 3-dimensional evaluation of aneurysm morphology. Contemporaneous parenchymal imaging with CT scan or MRI yields a wealth of information that may assist surgical planning. However, minor aneurysmal hemorrhage may not be detected with noninvasive methods.

A study of 20 years of screening results of individuals with a positive family history of SAH found that the yield of long-term screening is substantial even after more than 10 years of follow-up and two initial negative screens. These data suggest that repeated screening should be considered in individuals with 2 or more first-degree relatives who had SAH or unruptured intracranial aneurysms. [5, 6]


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