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. 2025 Sep 12;17(10):1066-1070.
doi: 10.1136/jnis-2024-022154.

Prevalence of unruptured intracranial aneurysms (UIAs) examined in the trauma population

Barrett Schwartz  1 , Vincent Nguyen  2 , Michael Barats  3 , Mustafa Motiwala  1 , Sean Himel  1 , David M Weatherford  4 , Violiza Inoa-Acosta  5 , Nitin Goyal  5 , Nickalus R Khan  1   5 , Daniel Hoit  1   5 , Lucas Elijovich  5 , Adam S Arthur  1   5 , Christopher Nickele  6   5
Affiliations

Prevalence of unruptured intracranial aneurysms (UIAs) examined in the trauma population

Barrett Schwartz et al. J Neurointerv Surg. .

Abstract

Background: Previous data on the prevalence of unruptured intracranial aneurysms (UIAs) vary widely, and studies based on these data are plagued with unintentional bias. Accurate prevalence data are paramount for any physician who counsels patients with intracranial aneurysms on rupture risk and treatment. We therefore sought to determine a more accurate number for the true prevalence of UIAs.

Methods: A retrospective chart review was conducted at a level 1 trauma center and tertiary care hospital in an urban setting between 2019 and 2020. Inclusion criteria included patients admitted with blunt trauma. Exclusion criteria included not having a head and neck CTA performed and read by an attending radiologist. All head and neck CTA radiology reads were reviewed for incidentally discovered UIAs. Subgroup analysis was performed by age group, race, and gender.

Results: A total of 5978 out of 8999 patients met the inclusion criteria, and 54 patients with 58 total aneurysms were identified giving an overall prevalence of 0.9%. Subgroup analysis was performed for all age groups, genders, and racial groups.

Conclusion: The overall aneurysm prevalence was found to be 0.9% in this sample. This rate is lower than rates previously cited in the literature and those quoted in local practice. This finding has significant implications when attempting to understand average rupture risk. Further studies are needed to power more subgroup analyses to use a more personalized approach to understanding an individual's risk of rupture.

Keywords: Aneurysm; Trauma.

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Conflict of interest statement

Competing interests: VI-A is a consultant for Siemens and Penumbra and received research support from Medtronic. DH is a consultant for Covidien/Medtronic and Microvention and is a shareholder of Cerebrotech, Marblehead Medical, and Silver Bullett. LE is a consultant for Balt, Cerenovus, Medtronic, MicroVention, Penumbra, and Stryker. ASA is a consultant for Johnson and Johnson, Medtronic, Microvention, Penumbra, Scientia, Siemens, and Stryker; received research support from Balt, Cerenovus, Medtronic, Microvention, Penumbra, Siemens, and Stryker; and is a shareholder in Bendit, Cerebrotech, Endostream, Magneto, Marble-head, Neurogami, Serenity, Synchron, TriadMedical, and VascularSimulations. CN is a consultant for Leica and received research support from Microvention.

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