Rinkel et al identified risk factors associated with rupture of intracranial saccular aneurysms. These can help identify which patients are at low or high risk for rupture. The authors are from the University of Utrecht in The Netherlands.


Risk factors associated with rupture:

(1) female gender (relative risk 2.1)

(2) symptomatic aneurysms (relative risk 8.2)

(3) size > 10 mm (relative risk 5.5)

(4) located in the posterior circulation (relative risk 4.1)


The annual risk of rupture for an asymptomatic aneurysm <= 10 mm was about 0.7% per year.


Additional factors associated with rupture but with lower relative risks:

(1) older age (1.7 for 60-79 years of age vs 40-59)

(2) "additional" aneurysm (one found unruptured when evaluating a ruptured aneurysm; relative risk 1.7 vs asymptomatic aneurysm)


For the implementation, I made up a risk score by adding the relative risks after rounding the values. This approach has not be tested or validated.


To read more or access our algorithms and calculators, please log in or register.