American Heart Association issues aneurysm recommendations

October 29, 2000

DALLAS, Oct. 31 - The American Heart Association has issued its first recommendations for physicians to follow for treating weakened blood vessels in the brain that have not yet ruptured. Recommendations for treating these unruptured intracranial aneurysms are published in the Oct. 31 issue of Circulation: Journal of the American Heart Association and the November issue of Stroke: Journal of the American Heart Association.

Aneurysms are blood filled pouches that form in weak spots of an artery wall. They can be difficult to detect and may not be dangerous if they remain intact. However, if one bursts in the brain, a deadly stroke called subarachnoid hemorrhage results.

"It is difficult to predict which unruptured aneurysms will rupture and which ones will never bleed," says Joshua Bederson, M.D. director of cerebrovascular surgery at Mount Sinai Hospital, New York, and chairman of the association's Stroke Council task force. "Since all treatments carry at least some risk of complications, deciding which patients should be treated is critical."

Whether to treat and how to treat patients with unruptured aneurysms has been controversial. The Stroke Council of the American Heart Association formed a task force to review existing literature and to develop treatment guidelines.

It is believed that 1 percent to 5 percent of the population may harbor unruptured brain aneurysms. Approximately six people in 100,000, or about 15,000 Americans, have a stroke from a ruptured aneurysm each year. Symptoms depend on the size and location of the aneurysm in the brain and may include impaired vision and headaches. However, the majority remain symptomless until they rupture.

The task force consensus is that widespread screening for people without symptoms is unnecessary. Screening should be considered for individuals with a family history of aneurysm or subarachnoid hemorrhage or those with certain genetic syndromes which might make them more susceptible to aneurysm formation.

In addition, the task force recommends that treatment of small aneurysms (less than 10mm) that have no symptoms should depend on the patient's age, severity and progression of the aneurysm.

"We recommend considering surgery for young patients regardless of aneurysm size, and for anyone with aneurysm symptoms, a previous ruptured aneurysm or any growth of the aneurysm," says Bederson. "We favor observation in older patients with the smallest symptomless aneurysms due to the higher risk of treatment and the shorter life expectancy."

Close observation with repeated brain scans is recommended for those who do not undergo surgery.

"We hope these guidelines will serve as a framework for the development of treatment plans for individuals with unruptured intracranial aneurysms and a basis for future research," says Bederson.
Task force members are Issam A. Awad, M.D.; David O. Wiebers, M.D.; David Piepgras, M.D.; E. Clarke Haley, Jr., M.D.; Thomas Brott, M.D.; George Hademenos, Ph.D.; Douglas Chyatte, M.D., Robert Rosenwasser, M.D.; and Cynthia Caroselli, R.N.

American Heart Association

Related Stroke Articles from Brightsurf:

Stroke alarm clock may streamline and accelerate time-sensitive acute stroke care
An interactive, digital alarm clock may speed emergency stroke care, starting at hospital arrival and through each step of the time-sensitive treatment process.

Stroke patients with COVID-19 have increased inflammation, stroke severity and death
Stroke patients who also have COVID-19 showed increased systemic inflammation, a more serious stroke severity and a much higher rate of death, compared to stroke patients who did not have COVID-19, according a retrospective, observational, cross-sectional study of 60 ischemic stroke patients admitted to UAB Hospital between late March and early May 2020.

'Time is vision' after a stroke
University of Rochester researchers studied stroke patients who experienced vision loss and found that the patients retained some visual abilities immediately after the stroke but these abilities diminished gradually and eventually disappeared permanently after approximately six months.

More stroke awareness, better eating habits may help reduce stroke risk for young adult African-Americans
Young African-Americans are experiencing higher rates of stroke because of health conditions such as high blood pressure, diabetes and obesity, yet their perception of their stroke risk is low.

How to help patients recover after a stroke
The existing approach to brain stimulation for rehabilitation after a stroke does not take into account the diversity of lesions and the individual characteristics of patients' brains.

Kids with headache after stroke might be at risk for another stroke
A new study has found a high incidence of headaches in pediatric stroke survivors and identified a possible association between post-stroke headache and stroke recurrence.

High stroke impact in low- and middle-income countries examined at 11th World Stroke Congress
Less wealthy countries struggle to meet greater need with far fewer resources.

Marijuana use might lead to higher risk of stroke, World Stroke Congress to be told
A five-year study of hospital statistics from the United States shows that the incidence of stroke has risen steadily among marijuana users even though the overall rate of stroke remained constant over the same period.

We need to talk about sexuality after stroke
Stroke survivors and their partners are not adequately supported to deal with changes to their relationships, self-identity, gender roles and intimacy following stroke, according to new research from the University of Sydney.

Standardized stroke protocol can ensure ELVO stroke patients are treated within 60 minutes
A new study shows that developing a standardized stroke protocol of having neurointerventional teams meet suspected emergent large vessel occlusion (ELVO) stroke patients upon their arrival at the hospital achieves a median door-to-recanalization time of less than 60 minutes.

Read More: Stroke News and Stroke Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to