{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T01:40:18Z","timestamp":1783647618316,"version":"3.55.0"},"reference-count":15,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,6]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Investigators conducting the International Study of Unruptured Intracranial Aneurysms, sponsored by the National Institutes of Health, sought to evaluate predictors of future hemorrhage in patients who had unruptured mirror aneurysms. These paired aneurysms in bilateral arterial positions mirror each other; their natural history is unknown.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Centers in the US, Canada, and Europe enrolled patients for prospective assessment of unruptured intracranial aneurysms. Central radiological review confirmed the presence or absence of mirror aneurysms in patients without a history of prior subarachnoid hemorrhage (SAH) (Group 1). Outcome at 1 and 5 years and aneurysm characteristics are compared.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Of 3120 patients with aneurysms treated in 61 centers, 376 (12%) had mirror aneurysms, which are more common in women than men (82% [n = 308] vs 73% [n = 1992], respectively; p &lt;0.001) and in patients with a family history of aneurysm or SAH (p &lt;0.001).<\/jats:p>\n<jats:p>Compared with patients with nonmirror saccular aneurysms, a greater percentage of patients with mirror aneurysms had larger (&gt;10 mm) aneurysms (mean maximum diameter 11.7 vs 10.4 mm, respectively; p &lt;0.001). The most common distribution for mirror aneurysms was the middle cerebral artery (34% [126 patients]) followed by noncavernous internal carotid artery (32% [121]), posterior communicating artery (16% [60]), cavernous internal carotid artery (13% [48]), anterior cerebral artery\/anterior communicating artery (3% [13]), and vertebrobasilar circulation (2% [8]). When these patients were compared with patients without mirror aneurysms, no statistically significant differences were found in age (mean age 54 years in both groups), blood pressure, smoking history, or cardiac disease. Aneurysm rupture rates were similar (3.0% for patients with mirror aneurysms vs 2.8% for those without).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Overall, patients with mirror aneurysms were more likely to be women, to report a family history of aneurysmal SAH, and to have larger aneurysms. The presence of a mirror aneurysm was not an independent predictor of future SAHs.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2012.1.jns11779","type":"journal-article","created":{"date-parts":[[2012,3,9]],"date-time":"2012-03-09T15:04:42Z","timestamp":1331305482000},"page":"1238-1241","source":"Crossref","is-referenced-by-count":37,"title":["Mirror aneurysms: a reflection on natural history"],"prefix":"10.3171","volume":"116","author":[{"given":"Irene","family":"Meissner","sequence":"first","affiliation":[{"name":"Departments of Neurology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Torner","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Iowa, Iowa City, Iowa; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Huston","sequence":"additional","affiliation":[{"name":"Radiology, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele L.","family":"Rajput","sequence":"additional","affiliation":[{"name":"Department of Neurology, Royal University Hospital, Saskatoon, Saskatchewan, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David O.","family":"Wiebers","sequence":"additional","affiliation":[{"name":"Departments of Neurology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyell K.","family":"Jones","sequence":"additional","affiliation":[{"name":"Departments of Neurology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert D.","family":"Brown","sequence":"additional","affiliation":[{"name":"Departments of Neurology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns11779","series-title":"Acta Neurochir (Wien)","first-page":"1091","article-title":"Multiple mirror-like intracranial aneurysms. Report of a case and review of the literature","volume":"148","author":"Baccin","year":"2006"},{"key":"b2-jns11779","series-title":"Neuropsychiatry Neuropsychol Behav Neurol","first-page":"111","article-title":"The telephone interview for cognitive status","volume":"1","author":"Brandt","year":"1988"},{"key":"b3-jns11779","series-title":"N Engl J Med","first-page":"733","article-title":"The risk of subarachnoid and intracerebral hemorrhages in blacks as compared with whites","volume":"326","author":"Broderick","year":"1992"},{"key":"b4-jns11779","series-title":"Stroke","first-page":"373","article-title":"Stroke incidence, prevalence, and survival: secular trends in Rochester, Minnesota, through 1989","volume":"27","author":"Brown","year":"1996"},{"key":"b5-jns11779","series-title":"Surg Neurol","first-page":"541","article-title":"A comparison of risk factors in the etiology of mirror and nonmirror multiple intracranial aneurysms","volume":"61","author":"Casimiro","year":"2004"},{"key":"b6-jns11779","series-title":"J Neurosurg","first-page":"728","article-title":"Risk factors for the formation of multiple intracranial aneurysms","volume":"94","author":"Ellamushi","year":"2001"},{"key":"b7-jns11779","series-title":"N Engl J Med","first-page":"1725","article-title":"Unruptured intracranial aneurysms\u2014risk of rupture and risks of surgical intervention","volume":"339","author":"International Study of Unruptured Intracranial Aneurysms Investigators","year":"1998"},{"key":"b8-jns11779","series-title":"Scott Med J","first-page":"200","article-title":"Cerebral vascular accidents in patients over the age of 60. II. Prognosis","volume":"2","author":"Rankin","year":"1957"},{"key":"b9-jns11779","series-title":"Neurosurgery","first-page":"2","article-title":"Analysis of 561 patients with 690 middle cerebral artery aneurysms: anatomic and clinical features as correlated to management outcome","volume":"38","author":"Rinne","year":"1996"},{"key":"b10-jns11779","series-title":"Neurosurgery","first-page":"803","article-title":"Multiple intracranial aneurysms in a defined population: prospective angiographic and clinical study","volume":"35","author":"Rinne","year":"1994"},{"issue":"Suppl","key":"b11-jns11779","series-title":"Am J Epidemiol","first-page":"S27","article-title":"Determinants of the number of intracranial aneurysms","volume":"161","author":"Torner","year":"2005"},{"key":"b12-jns11779","series-title":"N Engl J Med","first-page":"1821","article-title":"Incidental findings on brain MRI in the general population","volume":"357","author":"Vernooij","year":"2007"},{"key":"b13-jns11779","series-title":"N Engl J Med","first-page":"696","article-title":"The natural history of unruptured intracranial aneurysms","volume":"304","author":"Wiebers","year":"1981"},{"key":"b14-jns11779","series-title":"J Neurosurg","first-page":"43","article-title":"Prevalence of asymptomatic incidental aneurysms: review of 4568 arteriograms","volume":"96","author":"Winn","year":"2002"},{"key":"b15-jns11779","series-title":"Surg Neurol","first-page":"361","article-title":"Multiple \u201cmirror\u201d aneurysms involving intracavernous carotid arteries and vertebral arteries: case report","volume":"54","author":"Yamada","year":"2000"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/116\/6\/article-p1238.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/116\/6\/article-p1238.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/116\/6\/article-p1238.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T00:50:22Z","timestamp":1679878222000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/116\/6\/article-p1238.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2012,6]]},"references-count":15,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2012.1.jns11779","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,6]]}}}