Radiation-associated intracranial aneurysms: A systematic review of clinical presentation, morphology, and treatment outcomes.
Maria Cristina Barba, Roberta Muni, Angela Sardaro et al.
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In 30 seconds
This systematic review examined published cases of radiation-associated intracranial aneurysms (RAIs) reported from 1984 to 2024, characterising presentation, anatomy, and treatment outcomes. It included 103 patients with 142 aneurysms; mean time from radiotherapy to diagnosis was 11.3 years (range: 2-21 years). Half presented with subarachnoid hemorrhage, and 45.1% had dissecting or nonsaccular morphology. About 65% underwent treatment. Adequate occlusion was reported in 66% overall, including 73.1% of endovascularly treated aneurysms and 48.5% of surgically treated aneurysms.
Key findings
- Mean latency from radiotherapy to aneurysm diagnosis was 11.3 years (range: 2-21 years).
- Half of the aneurysms presented with subarachnoid hemorrhage; 45.1% were dissecting or nonsaccular.
- Adequate occlusion was achieved in 66% overall, 73.1% after endovascular treatment, and 48.5% after surgery.
Why it matters
The review describes a potentially serious late vascular complication that may emerge years after cranial or cervical radiotherapy. Its reported latency and frequent hemorrhagic presentation underscore the importance of recognising the possibility of RAIs in long-term survivors. The findings also summarise the varied morphology and treatment outcomes, while highlighting that evidence remains insufficient to define screening or management strategies.
What to keep in mind
The review synthesises published cases, and the mean radiological follow-up was 19.5 months; the abstract notes that further research is needed to establish screening and management strategies.