We would like to commend the authors Watanabe et al. for their study assessing the rate of growth of unruptured versus ruptured aneurysms on magnetic resonance angiography (MRA).1 The natural history of small, unruptured intracranial aneurysms (UIAs) is not well understood, and small UIAs have low growth and rupture rates reported in the literature.2 We have a few questions for the authors and concerns about the conclusions.

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