Management of small unruptured intracranial aneurysms in Australia and New Zealand

Aim To evaluate current management of small unruptured anterior circulation cerebral aneurysms in New Zealand and Australia. Method A survey was performed of 35 neurosurgeons and interventional neuroradiologists practising in Australia and New Zealand regarding their management of five representative cases of anterior circulation aneurysms ranging from 3-6 mm in size. Results There was a 64% overall active treatment rate with patient age being the most important determining factor. For the 4 cases under the age of 50 years there was a 78% active treatment rate. Other factors influencing decision making are discussed. Conclusion Despite controversial available literature to guide management most small anterior circulation aneurysms in New Zealand and Australia would be recommended for active treatment by microsurgical clipping or endovascular coiling, particularly in younger patients.