PHASES Score
Predicts 5-year risk of rupture of intracranial aneurysms.
Advice
- Different cutoffs for high- and low-risk stratification exist. For example, Bijlenga et al. (2017) used a score ≤3 to define low risk but noted a non-negligible likelihood of rupture in this group.
- While this tool can provide a risk estimate, individual clinical judgment, specialist guidance, and shared decision-making remain critical in planning treatment.
Management
- All patients should receive:
- Education about the risk of subarachnoid hemorrhage, when to seek immediate medical attention, and activities to avoid.
- Hypertension management.
- Appropriate treatment for comorbidities.
- Smoking cessation counseling.
- For lower-risk patients: Consider conservative management with periodic imaging (CTA or MRA) and regular follow-up.
- For higher-risk patients:
- Engage in shared decision-making regarding potential surgical or endovascular intervention.
- Collaborate with neurosurgery or neurointerventional radiology for further evaluation.