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Volume 358:853-855 February 21, 2008 Number 8
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Incidental Findings on Brain MRI

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 by Vernooij, M. W.
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To the Editor: Vernooij et al. (Nov. 1 issue)1 have contributed valuable knowledge about the prevalence of asymptomatic intracranial lesions. However, we disagree with their statement that many incidental lesions do not merit further evaluation or treatment.

The authors cite results of the International Study of Unruptured Intracranial Aneurysms (ISUIA) to justify not further evaluating small aneurysms,2 but conventional magnetic resonance sequences used in this study are unreliable in characterizing aneurysms. Digital subtraction angiography or computed tomographic or magnetic resonance angiography is a superior diagnostic technique.3 Furthermore, a significant proportion of subarachnoid hemorrhages result from small aneurysms, mandating careful risk . . . [Full Text of this Article]




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