The MEDLINE database was searched with the terms “intracranial aneurysm”, “subarachnoid hemorrhage”, “screening”, “family”, “polycystic kidney disease”, and “risk factor” for articles published between 2000 and July 2004.
Personal ViewIntracranial aneurysm screening: indications and advice for practice
Section snippets
Risk factors
Factors associated with the risk of intracranial aneurysm and subarachnoid haemorrhage can be classified as modifiable or non-modifiable. Risk factors that can be modified include active smoking, hypertension, excessive alcohol consumption, and possibly the use of oestrogens.1, 2, 3, 4, 5, 6, 7 Some case-control studies also found that intake of coffee and use of cocaine are associated with increased risk,8, 9 but more studies are needed before individuals with additional risk factors for
Risks and consequences for treatment
The goal of screening is not to detect or to treat an aneurysm, but to increase the number of quality years of life. Therefore, before intracranial vessels are imaged, the risks and benefits of screening should be weighed. This process includes calculation of the risks of diagnostic procedures and treatment and the gain in life expectancy by preventive treatment of aneurysms detected by screening. But the assessment of risks should also include the amount of anxiety before screening, the
Search strategy and selection criteria
References (69)
- et al.
Alpha 1-antitrypsin deficiency in intracranial aneurysms and cervical artery dissection
Lancet
(1994) - et al.
Familial clustering of ruptured intracranial aneurysms in autosomal dominant polycystic kidney disease
Am J Kidney Dis
(2001) - et al.
Association of mutation position in polycystic kidney disease 1 (PKD1) gene and development of a vascular phenotype
Lancet
(2003) - et al.
Intracranial aneurysms in autosomal dominant polycystic kidney disease
Kidney Int
(1994) - et al.
Intracranial aneurysms and autosomal dominant polycystic kidney disease: followup study by magnetic resonance angiography
J Urol
(2000) - et al.
Recurrence of intracranial aneurysms in autosomal-dominant polycystic kidney disease
Kidney Int
(2003) - et al.
Follow-up of intracranial aneurysms in autosomal-dominant polycystic kidney disease
Kidney Int
(2004) - et al.
Cerebral aneurysm associated with von Recklinghausen's neurofibromatosis: a case report
Surg Neurol
(1998) - et al.
Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment
Lancet
(2003) - et al.
Monozygotic twins not identical with respect to the existence of intracranial aneurysms: a case report
Surg Neurol
(1994)
Identical cerebral aneurysms in siblings: report of two families
J Clin Neurosci
Risk factors for subarachnoid hemorrhage: a systematic review
Stroke
Rapid development of giant fusiform cerebral aneurysms in angiographically normal vessels
Neurology
Hormonal factors and risk of aneurysmal subarachnoid hemorrhage: an international population-based, case-control study
Stroke
Risk factors for subarachnoid hemorrhage
Neurosurgery
Subarachnoid hemorrhage: a preventable disease with a heritable component
Stroke
Risk factors for aneurysmal subarachnoid hemorrhage in Aomori, Japan
Stroke
Active and passive smoking and the risk of subarachnoid hemorrhage: an international population-based case-control study
Stroke
Risk factors for aneurysmal subarachnoid haemorrhage: the Tromso study
J Neurol Neurosurg Psychiatry
Major risk factors for aneurysmal subarachnoid hemorrhage in the young are modifiable
Stroke
Prevalence and risk of rupture of intracranial aneurysms: a systematic review
Stroke
Subarachnoid haemorrhage in first and second degree relatives of patients with subarachnoid haemorrhage
BMJ
Attributable risk of common and rare determinants of subarachnoid hemorrhage
Stroke
Aneurysms in relatives of patients with subarachnoid hemorrhage: frequency and risk factors
Neurology
Characteristics of intracranial aneurysms in patients with familial subarachnoid hemorrhage
Neurology
Familial subarachnoid hemorrhage: distinctive features and patterns of inheritance
Ann Neurol
Anticipation in familial intracranial aneurysms in consecutive generations
Eur J Hum Genet
Repeated screening for intracranial aneurysms in familial subarachnoid hemorrhage
Stroke
Saccular intracranial aneurysms in autosomal dominant polycystic kidney disease
J Am Soc Nephrol
Characteristics of intracranial aneurysms and subarachnoid haemorrhage in patients with polycystic kidney disease
J Neurol
Value of magnetic resonance angiography for the detection of intracranial aneurysms in autosomal dominant polycystic kidney disease
J Am Soc Nephrol
Recurrent rupture of intracranial aneurysms in autosomal dominant polycystic kidney disease
BMJ
Clinical and genetic features of Ehlers-Danlos syndrome type IV, the vascular type
N Engl J Med
Type III collagen deficiency in saccular intracranial aneurysms: defect in gene regulation?
Stroke
Cited by (100)
Vascular Complications in Autosomal Dominant Polycystic Kidney Disease: Perspectives, Paradigms, and Current State of Play
2023, Advances in Kidney Disease and HealthNeurovascular abnormalities in patients with Loeys-Dietz syndrome type III
2022, European Journal of Medical GeneticsDiagnosis and Treatment of Unruptured Intracranial Aneurysms and Aneurysmal Subarachnoid Hemorrhage
2021, Mayo Clinic ProceedingsCitation Excerpt :Catheter angiography is often used when there is a high clinical suspicion of an aneurysm with normal findings on noninvasive imaging.54 Compared with CTA and MRA, it is more expensive and carries procedural risks, including neurologic complications (1.0%-2.5%), injury to the femoral artery (0.05%-0.55%), groin hematoma (6.9%-10.7%), and contrast-induced nephropathy (1%-2%).55 The risk factors for aneurysmal growth can be divided into patient-specific factors, including female sex, hypertension, and smoking, and aneurysm-specific factors, including posterior circulation location, irregular shape, and large size.56
Genetics of intracranial aneurysm
2019, Bulletin de l'Academie Nationale de MedecineUnruptured intracranial aneurysms: An updated review of current concepts for risk factors, detection and management
2017, Revue NeurologiqueCitation Excerpt :The consequences of an aneurysmal subarachnoid hemorrhage (aSAH) are devastating, with at least a quarter of such patients not surviving the rupture or its immediate complications, while leaving roughly half the survivors with permanent disabling neurological deficits [4]. With the greater availability of technical improvements and the ever-widening indications for noninvasive vascular neuroimaging [5], unruptured intracranial aneurysms (UIAs) are increasingly being discovered incidentally and an steadily growing number of patients are being referred to or seeking counseling from specialized centers regarding opportunities for screening (for example, for fear of occult UIAs after a relative has suffered an aSAH) [6]. However, UIAs represent a challenging situation to manage for several reasons:
Screening and management of intracranial aneurisms in patients with autosomal dominant polycystic kidney disease
2017, Nephrologie et Therapeutique