Aspirin as a Promising Agent for Decreasing Incidence of Cerebral Aneurysm Rupture

A pproximately 2% of the general population harbor saccular intracranial aneurysms (IAs), lesions that are largely asymptomatic unless they rupture and produce a subarachnoid and/or intracerebral hemorrhage. The natural history of unruptured IAs, especially their propensity to bleed once discovered, remains controversial. Moreover, there is a poor understanding of several factors that may lead to IA rupture. One factor that has recently gained attention is the hypothesis that inflammation of the vessel and/or aneurysm wall may contribute in some way to a higher likelihood of rupture. 1 However, data supporting the clinical relevance of this hypothesis are lacking. In the present submission, 2 Hasan and colleagues use data from the International Study of Unruptured Intracranial Aneurysms (ISUIA) 3 to indirectly address this issue. The ISUIA database likely comprises the most extensive retrospective and prospective database on patients harboring unruptured IAs and contains clinical outcome as well as extensive demographic information. The authors have proposed that if inflammation is related to IA rupture risk, then this risk would be reduced in patients who are taking anti-inflammatory agents.