Juvela et al reported a treatment score for a patient with an unruptured intracranial aneurysm. This can help to identify a patient who does or who does not require treatment. The author is from the University of Helsinki.
Patient selection: unruptured intracranial aneurysm
Parameters:
(1) age in years
(2) current smoking
(3) diameter of the aneurysm in mm
(4) location
Parameter
Finding
Points
age in years
< 40 years
2
>= 40 years
0
current smoking
no
0
yes
2
diameter
< 7 mm
0
>= 7 mm
3
location
anterior communicating artery
5
internal carotid artery bifurcation
4
posterior communicating artery
2
other
0
total score =
= SUM(points for all of the parameters)
Parameters:
• minimum score: 0
• maximum score: 12
• The higher the score the greater the risk of rupture over time.
• A score >= 5 is associated with benefit from therapy.
• A score from 1 to 4 would benefit from conservative management.
• A patient with a score of 0 should not be treated.
Score
Rupture Rate 10 Years
Rupture Rate 30 years
0
0%
0%
1 to 4
3%
18%
5 to 8
16%
49%
9 to 12
60%
80%
Performance:
• The area under the ROC curve is 0.76.
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