Natural History of Intracranial Aneurysms

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Abstract
To the Editor: The report by Wiebers et al.1 in the March 19 issue serves a useful purpose in emphasizing that size is the key variable in estimating the risk of future rupture of an asymptomatic and incidentally discovered aneurysm. The physics of aneurysmal rupture dictates that this must be the case.2 However, we take strong exception to the authors' conclusion that aneurysms less than 10 mm in diameter are benign and need not be considered for prophylactic surgical treatment. Their own studies testify to the malignant nature of intracranial aneurysms once they are ruptured: the death rate exceeded 50 . . .