As the incidental diagnosis of unruptured intracranial aneurysms has been increasing, several scores were developed to predict risk of rupture and growth to guide the management choice. We retrospectively applied these scores to a multicenter series of patients with subarachnoid hemorrhage to test whether they would have predicted the risk of bleeding in the event of aneurysm discovery previous to its rupture. Demographical, clinical, and radiological information of 245 adults were retrieved from two neurovascular centers’ database. Data were pooled and PHASES, UCAS, and ELAPSS scores were retrospectively calculated for the whole population and their performances in identifying aneurysms at risk of rupture were compared. Mean PHASES, UCAS, and ELAPSS scores were 5.12 ± 3.08, 5.09 ± 2.62, and 15.88 ± 8.07, respectively. Around half (46%) of patients would have been assigned to the low- or very low-risk class (5-year rupture risk < 1%) in PHASES. Around 28% of patients would have been in a low-risk class, with a probability of 3-year rupture risk < 1% according to UCAS. Finally, ELAPSS score application showed a wider distribution among the risk classes, but a significant proportion of patients (45.5%) lie in the low- or intermediate-risk class for aneurysm growth. A high percentage of patients with ruptured aneurysms in this multicenter cohort would have been assigned to the lower risk categories for aneurysm growth and rupture with all the tested scores if they had been discovered before the rupture. Based on these observations, physicians should be careful about drawing therapeutic conclusions solely based on application of these scores.

随着颅内动脉瘤破裂的偶然诊断不断增加，已开发出多个评分来预测破裂和生长的风险，以指导治疗的选择。我们回顾性地将这些评分应用于多中心类蛛网膜下腔出血患者，以测试他们是否能够预测破裂前发现动脉瘤的出血风险。从两个神经血管中心的数据库中检索了245位成年人的人口统计学，临床和放射学信息。汇总数据并回顾性计算整个人群的PHASES，UCAS和ELAPSS评分，并比较它们在识别有破裂风险的动脉瘤中的表现。平均PHASES，UCAS和ELAPSS得分分别为5.12±3.08、5.09±2.62和15.88±8.07。大约一半（46％）的患者将被分入PHASES的低风险或极低风险类别（5年破裂风险<1％）。根据UCAS，大约28％的患者属于低危人群，其3年破裂风险的可能性<1％。最后，ELAPSS评分应用程序显示风险类别之间的分布范围更广，但很大一部分患者（45.5％）属于低或中等风险类别的动脉瘤生长。如果在破裂前被发现，在这个多中心队列中，高比例的动脉瘤破裂患者将被分配到动脉瘤生长和破裂的较低风险类别，并且所有测试评分均被分配。基于这些观察结果，医生应谨慎考虑仅根据这些评分的应用得出治疗结论。