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U.VA. PARTICIPATES IN BRAIN ANEURYSM STUDY SUGGESTING BENEFIT FROM PROACTIVE TREATMENT

There is new evidence that aneurysm size, location and a previous history of a ruptured aneurysm are the best overall predictors of whether patients will experience a ruptured aneurysm in the future, according to investigative studies, including the 12-year Study of Unruptured Intracranial Aneurysms (ISUIA).

The Department of Neurosurgery at the University of Virginia Health System was one of 61 centers in the U.S., Canada and Europe participating in the Phase II ISUIA study of over 4,000 patients, with 175 patients participating at U.Va.  The study indicates that smaller aneurysms may be riskier to patients than first believed. 

“Which patients with unruptured aneurysms should be treated is one of the burning questions in neurosurgery today, “ said Dr. Neal Kassell, an author and lead investigator of the study and professor of neurosurgery at U.Va. “This international study, coordinated with the help and expertise of the neurosurgery faculty at U.Va., provides us with additional useful information to advise patients on courses of treatment.”

The ISUIA study suggested that patients with unruptured aneurysms between seven to nine millimeters in diameter, in certain locations in the brain, are at risk and should be proactively treated rather than conservatively managed through monitoring. Patients with aneurysms smaller than seven millimeters were at low risk for rupture. In addition, the study found that aneurysms located toward the front of the brain were less risky than those in the back.

“Neurosurgeons must individualize the treatment of each patient based on a number of factors, including those in the study,” Kassell said. “In addition to the characteristics of the aneurysm, the patients age, general health and personal medical philosophy must be considered, as well as the capabilities of the surgeon and hospital.”

An aneurysm is an abnormal dilation or bulge in a blood vessel, which often gets bigger over time. When a brain aneurysm ruptures, blood flows into the space surrounding the brain, resulting in a subarachnoid hemorrhage. It can be the deadliest form of stroke and affects about 35,000 people in the U.S. every year. About half of all patients with ruptured brain aneurysms will die within one month. Many of those who survive a rupture suffer permanent disabilities. It’s estimated that up to 17 million Americans may have unruptured intracranial aneurysms.  

U.Va.’s Department of Neurosurgery is one of the nation’s leading centers in the treatment of aneurysms. U.Va. is Virginia’s most prominent research and treatment center for disorders affecting the brain and nervous system and is consistently ranked among the nation’s top fifty neurology and neurosurgery centers by U.S. News & World Report.

August 20, 2003