Clinical Neuroradiology

, Volume 29, Issue 4, pp 717–723 | Cite as

Growth of Asymptomatic Intracranial Fusiform Aneurysms

Incidence and Risk Factors
  • Jusun Moon
  • Young Dae ChoEmail author
  • Dong Hyun Yoo
  • Jeongjun Lee
  • Hyun-Seung Kang
  • Won-Sang Cho
  • Jeong Eun Kim
  • Li Zhang
  • Moon Hee Han
Original Article



Growth of intracranial fusiform aneurysms (IFA) may become clinically problematic through a mass effect or rupture. We investigated the growth rate and factors contributing to growth in asymptomatic untreated IFA.


As a retrospective review, we assessed patients diagnosed with asymptomatic IFA between August 2000 and September 2014, all untreated. No acute or symptomatic dissecting lesions were considered. Clinical and serial angiographic follow-up data were analyzed, defining growth as expansion > 2 mm in one or more dimensions. A binary logistic regression model and Kaplan-Meier method were applied for statistical analysis.


The mean follow-up in the 82 eligible patients was 47.7 months (range 12–190 months). Among them, 7 aneurysms (8.5%, 2.1% per aneurysm year) demonstrated growth (in any dimension). In univariate analysis, height and multiplicity of aneurysms emerged as significant factors in terms of growth. Height remained an independent risk factor in the binary logistic regression model, with receiver operating curves indicating a threshold of 6.9 mm initial height in determining IFA growth (area under the curve 0.804). Of the patients six (except one who underwent endovascular treatment) were observed during continued follow-up monitoring. All six lesions were stable in serial imaging tests, without further detectable growth or rupture (mean 33 months).


Most (91.5%) of the asymptomatic and untreated IFAs studied proved to be stable, with no continued growth; however, because aneurysm height proved to be independently predictive of growth (lesions > 6.9 mm being at risk), periodic imaging is required in those left untreated. Growing but still asymptomatic aneurysms call for the utmost caution and care in decision-making.


Aneurysm Fusiform Unruptured Growth Follow-up 


Compliance with ethical guidelines

Conflict of interest

J. Moon, Y.D. Cho, D.H. Yoo, J. Lee, H.-S. Kang, W.-S. Cho, J.E. Kim, L. Zhang and M.H. Han declare that they have no competing interests.

Ethical standards

This study complied with the principles outlined in the Declaration of Helsinki and was approved by our institutional review board (Seoul National University Hospital).

Supplementary material

62_2018_695_MOESM1_ESM.docx (16 kb)
SUPPLEMENTAL TABLE 1. Location of intracranial fusiform aneurysms (n = 82)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Jusun Moon
    • 1
  • Young Dae Cho
    • 2
    Email author
  • Dong Hyun Yoo
    • 2
  • Jeongjun Lee
    • 2
  • Hyun-Seung Kang
    • 3
  • Won-Sang Cho
    • 3
  • Jeong Eun Kim
    • 3
  • Li Zhang
    • 4
  • Moon Hee Han
    • 2
    • 3
  1. 1.Department of Neurology, Korea University Anam HospitalKorea University College of MedicineSeoulKorea (Republic of)
  2. 2.Department of Radiology, Seoul National University HospitalSeoul National University College of MedicineSeoulKorea (Republic of)
  3. 3.Department of Neurosurgery, Seoul National University HospitalSeoul National University College of MedicineSeoulKorea (Republic of)
  4. 4.Department of NeurologyChina-Japan Union Hospital of Jilin UniversityChangchunChina

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