Long-Term Follow-up of Incidental Intracranial Aneurysms in Patients with Acute Ischemic Stroke

Background: The natural history of incidental intracranial aneurysms in patients with acute ischemic stroke is not well known. Therefore, we performed a 2-year follow-up of clinical outcomes and computed tomographic angiography (CTA) findings of incidentally found aneurysm in acute ischemic stroke patients. Methods: We included acute ischemic stroke patients who presented within 7 days of stroke onset. Patients underwent magnetic resonance imaging and CTA. Demographics, clinical outcome, presence of aneurysm, aneurysm type, location, and diameter of aneurysm were identified. CTA was performed at least 2 years after the initial examination. The development of all cases of hemorrhage related to aneurysmal rupture and long-term clinical outcome were checked. Results: Incidental intracranial aneurysms were found in 19 (6.1%) of the 314 patients. The sex (female) and old age were associated with the presence of incidental intracranial aneurysms. Favorable outcome (modified Rankin scale score 0-2) at 3 months showed no difference between the patients with aneurysm and those without (72.2% v 75.2%; P = .78). No aneurysm rupture or subarachnoid hemorrhage has occurred during the 2-year follow-up period. Follow-up CTA could be performed in 10 out of the 19 patients with aneurysm. Nine of them showed no change regarding to aneurysm shape and size, and the aneurysm disappeared in 1 patient. Conclusions: In our study, the prevalence of incidental aneurysm among acute ischemic stroke patients was 6.1%. After 2 years of follow-up, there was no aneurysm rupture or subarachnoid hemorrhage, and the diameter and shape of aneurysms did not change except for 1 patient in whom the aneurysm disappeared.