Commentary

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This clinical study again confirms our general understanding that 3-dimensional rotational angiography offers a precise determination of size and shape for both ruptured and unruptured intracranial aneurysm, and demonstrates that in a consecutive series of more than 100 patients, there were no significant size differences between ruptured and unruptured lesions. The study also reinforces the finding of other investigators that the mean diameter of ruptured aneurysms is 6 to 7 mm and that most ruptured lesions are less than 10 mm in diameter.

Although the authors' attempt to reconcile these facts with the very different results of the International Study of Unruptured Intracranial Aneurysms is not satisfying, their study again points out the malignant potential of small unruptured aneurysms.