Intracranial Aneurysms in Relatives of Aneurysm Patients
Intracranial Aneurysms in Relatives of Aneurysm Patients
Object. A familial predisposition toward cerebral aneurysms has been previously described in patients with two or more affected family members. In the present study the familial incidence of unruptured intracranial aneurysms was studied in 96 patients with at least one first-degree relative (parent, sibling, or child) in whom a cerebral aneurysm was diagnosed.
Methods. All patients were between 20 and 70 years of age and underwent three-dimensional fast-spin echo magnetic resonance imaging. Sixty-one patients (63.5%) were women. The majority of patients (84%) were caucasian and the remainder were Hispanic (13%) or African-American (3%). No patient suffered a medical condition (excluding hypertension and smoking) known to be associated with cerebral aneurysm formation.
In four patients at least one aneurysm was found (two harbored multiple aneurysms). Three of the four patients were women. Two of the patients were siblings. The estimated prevalence in first-degree relatives was 4.2% (95% confidence interval 1.2-10.1). Of note, the mean age in the current study population was 39 years. The authors of recent metaanalyses have suggested that the prevalence of nonfamilial aneurysms is approximately 2%, despite earlier reports in which higher figures were cited.
Conclusions. The authors conclude that first-degree relatives of patients with aneurysms are at higher risk for harboring an intracranial aneurysm.
A genetic predisposition for harboring saccular intracranial aneurysms has been described in the literature. In most studies investigators have targeted families with at least two index cases of cerebral aneurysms. The reported prevalence of cerebral aneurysms in these targeted families varies from 2.418 to 29.4%. This prevalence has surpassed the nonfamilial incidence of cerebral aneurysms reported in most studies.
Given the extremely high rates of morbidity and mortality associated with aneurysm rupture, the goal of these studies has been to isolate high-risk populations to initiate treatment and avoid the severe sequelae of aneurysm hemorrhage. The benefits of operative intervention may outweigh the surgery-related morbidity and mortality, thus increasing life expectancy.
We studied the prevalence of intracranial aneurysms in first-degree relatives of patients with aneurysms. In contrast to most familial aneurysm studies, we required only one index family member to harbor a documented cerebral aneurysm. Our goal was to determine prospectively the risk of a first-degree relative harboring an asymptomatic cerebral aneurysm.
Object. A familial predisposition toward cerebral aneurysms has been previously described in patients with two or more affected family members. In the present study the familial incidence of unruptured intracranial aneurysms was studied in 96 patients with at least one first-degree relative (parent, sibling, or child) in whom a cerebral aneurysm was diagnosed.
Methods. All patients were between 20 and 70 years of age and underwent three-dimensional fast-spin echo magnetic resonance imaging. Sixty-one patients (63.5%) were women. The majority of patients (84%) were caucasian and the remainder were Hispanic (13%) or African-American (3%). No patient suffered a medical condition (excluding hypertension and smoking) known to be associated with cerebral aneurysm formation.
In four patients at least one aneurysm was found (two harbored multiple aneurysms). Three of the four patients were women. Two of the patients were siblings. The estimated prevalence in first-degree relatives was 4.2% (95% confidence interval 1.2-10.1). Of note, the mean age in the current study population was 39 years. The authors of recent metaanalyses have suggested that the prevalence of nonfamilial aneurysms is approximately 2%, despite earlier reports in which higher figures were cited.
Conclusions. The authors conclude that first-degree relatives of patients with aneurysms are at higher risk for harboring an intracranial aneurysm.
A genetic predisposition for harboring saccular intracranial aneurysms has been described in the literature. In most studies investigators have targeted families with at least two index cases of cerebral aneurysms. The reported prevalence of cerebral aneurysms in these targeted families varies from 2.418 to 29.4%. This prevalence has surpassed the nonfamilial incidence of cerebral aneurysms reported in most studies.
Given the extremely high rates of morbidity and mortality associated with aneurysm rupture, the goal of these studies has been to isolate high-risk populations to initiate treatment and avoid the severe sequelae of aneurysm hemorrhage. The benefits of operative intervention may outweigh the surgery-related morbidity and mortality, thus increasing life expectancy.
We studied the prevalence of intracranial aneurysms in first-degree relatives of patients with aneurysms. In contrast to most familial aneurysm studies, we required only one index family member to harbor a documented cerebral aneurysm. Our goal was to determine prospectively the risk of a first-degree relative harboring an asymptomatic cerebral aneurysm.
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