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Multicenter Study
. 2008 Jun;108(6):1132-8.
doi: 10.3171/JNS/2008/108/6/1132.

Screening for brain aneurysm in the Familial Intracranial Aneurysm study: frequency and predictors of lesion detection

Affiliations
Multicenter Study

Screening for brain aneurysm in the Familial Intracranial Aneurysm study: frequency and predictors of lesion detection

Robert D Brown Jr et al. J Neurosurg. 2008 Jun.

Abstract

Object: Approximately 20% of patients with an intracranial saccular aneurysm report a family history of intracranial aneurysm (IA) or subarachnoid hemorrhage. A better understanding of predictors of aneurysm detection in familial IA may allow more targeted aneurysm screening strategies.

Methods: The Familial Intracranial Aneurysm (FIA) study is a multicenter study, in which the primary objective is to define the susceptibility genes related to the formation of IA. First-degree relatives (FDRs) of those affected with IA are offered screening with magnetic resonance (MR) angiography if they were previously unaffected, are > or = 30 years of age, and have a history of smoking and/or hypertension. Independent predictors of aneurysm detection on MR angiography were determined using the generalized estimating equation version of logistic regression.

Results: Among the first 303 patients screened with MR angiography, 58 (19.1%) had at least 1 IA, including 24% of women and 11.7% of men. Ten (17.2%) of 58 affected patients had multiple aneurysms. Independent predictors of aneurysm detection included female sex (odds ratio [OR] 2.46, p = 0.001), pack-years of cigarette smoking (OR 3.24 for 20 pack-years of cigarette smoking compared with never having smoked, p < 0.001), and duration of hypertension (OR 1.26 comparing those with 10 years of hypertension to those with no hypertension, p = 0.006).

Conclusions: In the FIA study, among the affected patients' FDRs who are > 30 years of age, those who are women or who have a history of smoking or hypertension are at increased risk of suffering an IA and should be strongly considered for screening.

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Figures

Fig. 1
Fig. 1
Preoperative MR angiogram (A) and DS angiogram (B) demonstrating a 2-mm ACoA aneurysm (arrows), which was successfully treated with coil embolization. Magnetic resonance angiogram (C) and DS angiogram (D) obtained in another patient of a wide-necked 2-mm aneurysm on the left M1 branch.

Comment in

  • Detection of aneurysms.
    Cannon-Albright LA. Cannon-Albright LA. J Neurosurg. 2008 Jun;108(6):1130-1. doi: 10.3171/JNS/2008/108/6/1130. J Neurosurg. 2008. PMID: 18518715 No abstract available.

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