Unruptured intracranial aneurysm treatment score35
Patient-related | Age (single) | ||
<40 years | 4 | ||
40–60 years | 3 | ||
61–70 years | 2 | ||
71–80 years | 1 | ||
>80 years | 0 | ||
Risk factors (multiple) | |||
Previous SAH from different aneurysm | 4 | ||
Familial intracranial aneurysm or subarachnoid haemorrhage | 3 | ||
Japanese, Finnish, Inuit ethnicity | 2 | ||
Cigarette smoking | 3 | ||
Hypertension (blood pressure >140 mm Hg) | 2 | ||
Autosomal dominant polycystic kidney disease | 2 | ||
Current drug abuse | 1 | ||
Clinical symptoms (multiple) | |||
Cranial nerve deficit | 4 | ||
Clinical/radiological mass effect | 3 | ||
Thromboembolic event from UIA | 2 | ||
Epilepsy | 1 | ||
Other (multiple) | |||
Reduced QoL due to rupture fear | 2 | ||
Aneurysm multiplicity | 1 | ||
Life expectancy | |||
<5 years | 4 | ||
5–10 years | 3 | ||
>10 years | 1 | ||
Comorbid disease (multiple) | |||
Neurocognitive disorder | 3 | ||
Coagulopathies/thrombophilia | 2 | ||
Psychiatric disorder | 1 | ||
Aneurysm | Maximum diameter (single) | ||
<3.9 mm | 0 | ||
4.0–6.9 mm | 1 | ||
7.0–12.9 mm | 2 | ||
13.0–24.9 mm | 3 | ||
>25 mm | 4 | ||
Morphology (multiple) | |||
Irregularity or loculation | 3 | ||
Size ratio >3 or aspect ratio >1.6 | 1 | ||
Location (single) | |||
Basilar bifurcation | 5 | ||
Vertebrobasilar artery | 4 | ||
Anterior or posterior communicating artery | 2 | ||
Other (multiple) | |||
Aneurysm growth on serial imaging | 4 | ||
Aneurysm de novo formation on serial imaging | 3 | ||
Contralateral steno-occlusive disease | 1 | ||
Treatment | Age-related risk | ||
<40 years | 0 | ||
41–60 years | 1 | ||
61–70 years | 3 | ||
71–80 years | 4 | ||
>80 years | 5 | ||
Aneurysm size-related risk | |||
<6.0 mm | 0 | ||
6.0–10.0 mm | 1 | ||
10.1–20.0 mm | 3 | ||
>20 mm | 5 | ||
Aneurysm complexity-related risk | |||
High | 3 | ||
Low | 0 | ||
Intervention-related risk onstant | 5 | ||
Total score | |||
Score favours UIA | Repair | Conservative |
QoA, quality of life; UIA, unruptured incidental intracranial aneurysm.