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November 22/29, 2000

Aneurysm Guidelines

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JAMA. 2000;284(20):2585. doi:10.1001/jama.284.20.2585-JQU00009-2-1

For the first time, the American Heart Association (AHA) has issued guidelines for the treatment of patients with unruptured intracranial aneurysms.

The recommendations, published October 31 in Circulation, are intended as a framework for treatment plans and a foundation for future research. Based on the consensus of an AHA Stroke Council task force, the guidelines support screening—currently by magnetic resonance angiography—in people with a family history of aneurysm or subarachnoid hemorrhage, or a genetic predisposition to aneurysm formation. Treatment of asymptomatic aneurysms of less than 10 mm should depend on the patient's age and progression of the aneurysm. However, surgery should be considered for young patients and those who have symptoms, a previous ruptured aneurysm, or growth of the aneurysm. Observation with repeated brain scans is recommended for patients who do not undergo surgery.

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