Greving et al reported the PHASES score for identifying the risk of rupture for an incidental intracranial aneurysm. This can help to identify a patient who may benefit from an intervention to reduce risk. The authors are from multiple institutions from Europe, Japan and the United States.
Patient selection: incidental intracranial aneurysm, member of study population group
Outcome: 5-year rate of rupture
Parameters:
(1) population (P)
(2) hypertension (H)
(3) age (A)
(4) size of aneurysm in mm (S)
(5) earlier SAH from another aneurysm (E)
(6) site of aneurysm (S)
Parameter |
Finding |
Points |
population |
North American, non-Finnish European |
0 |
|
Japanese |
3 |
|
Finnish |
5 |
hypertension |
no |
0 |
|
yes |
1 |
age |
< 70 years |
0 |
|
>= 70 years |
1 |
size |
< 7 mm |
0 |
|
7 to 9.9 mm |
3 |
|
10 to 19.9 mm |
6 |
|
>= 20 mm |
10 |
earlier SAH |
no |
0 |
|
yes |
1 |
site of aneurysm |
internal carotid (ICA) |
0 |
|
middle cerebral (MCA) |
2 |
|
anterior cerebral (ACA), posterior communicating (Pcom), posterior circulation |
4 |
where:
• The posterior cerebral circulation includes the vertebral, basilar and posterior cerebral arteries.
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 22
• The higher the score the greater the risk of aneurysm rupture.
• A patient with a score >= 4 is more likely to undergo an intervention.
Total Score |
5-Year Rupture |
0 to 2 |
0.4% |
3 |
0.7% |
4 |
0.9% |
5 |
1.3% |
6 |
1.7% |
7 |
2.4% |
8 |
3.2% |
9 |
4.3% |
10 |
5.3% |
11 |
7.2% |
12 to 22 |
17.8% |