Hostname: page-component-848d4c4894-nmvwc Total loading time: 0 Render date: 2024-06-19T14:11:45.421Z Has data issue: false hasContentIssue false
  • English
  • Français

Risk of Intracranial Aneurysms in Families With Subarachnoid Hemorrhage

Published online by Cambridge University Press:  18 September 2015

Mark J. Alberts ,
Ana Quinones ,
Carmelo Graffagnino ,
Allan Friedman  and
Allen D. Roses
Mark J. Alberts*
Affiliation:
Division of Neurology, Department of Medicine, Duke University Medical Center, Stroke Acute Care Unit, Duke Hospital
Ana Quinones
Affiliation:
Division of Neurology, Duke University Medical Center, Durham, North Carolina, USA
Carmelo Graffagnino
Affiliation:
Division of Neurology, Duke University Medical Center, Durham, North Carolina, USA
Allan Friedman
Affiliation:
Department of Medicine; Division of Neurosurgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
Allen D. Roses
Affiliation:
Department of Neurobiology, Duke University Medical Center, Durham, North Carolina, USA
*
P.O. Box 3392, Duke University Medical Center, Durham, NC 27710 USA
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

Genetic factors may be important in the etiology of subarachnoid hemorrhage (SAH) and intracranial aneurysm (IA) formation. Several studies have reported the familial occurrence of SAH and IA, although in most cases asymptomatic family members were not studied with elective angiography. The examination of data from large sibships could provide important information about the frequency of IA occurrence in at-risk individuals and the mode of inheritance for familial SAH/1A.

Methods:

We reviewed published case series of sibships with SAH and at least four siblings, in which at least one sibling underwent elective angiography. Data were collected on age-of-onset, clinical events, presence of hypertension, angiographic findings, and outcome. Patients were classified as “affected” if they had a SAH or if an IA was detected by elective angiography, and “unaffected” if they were asymptomatic and had a negative angiogram.

Results:

Seven case series with 52 individuals (26 men and 26 women) met our inclusion criteria. The sibships ranged from 6 to 13 members. Most of the siblings (32 of 52, 61%) were asymptomatic, 18 (35%) had a SAH, and 2 (4%) had focal symptoms but no SAH. Elective angiography of 34 siblings showed an IA in 11 (32%) and was negative in 23 (68%). The overall rate of affecteds (SAH or IA) was 56%.

Conclusions:

Based on data from these sibships, angiography of asymptomatic at-risk siblings demonstrated an IA in almost one-third of cases. Familial SAH/IA segregated with a pattern that was consistent with an autosomal dominant trait in this selected series of sibships, although other factors could produce these findings.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 22 , Issue 2 , May 1995 , pp. 121 - 125
Copyright
Copyright © Canadian Neurological Sciences Federation 1995

References

1.Elshunnar, K., Whittle, I.Familial intracranial aneurysms: report of five families. Br J Neurosurg 1990; 4: 181–186.CrossRefGoogle ScholarPubMed
2.terBerg, H., Dippel, D., Limburg, M., Schievink, W., van Gijn, J.Familial intracranial aneurysms: a review. Stroke 1992; 23: 1024–1030.CrossRefGoogle Scholar
3.Lozano, A., Leblanc, R.Familial intracranial aneurysms. J Neurosurg 1987; 66: 522–528.CrossRefGoogle ScholarPubMed
4.Norrgard, O., Angquist, K., Fodstad, H., Forsell, A., Lindberg, M.Intracranial aneurysms and heredity. Neurosurgery 1987; 20: 236–239.CrossRefGoogle ScholarPubMed
5.Bannerman, R., Ingall, G., Graf, C.The familial occurrence of intracranial aneurysms. Neurology 1970; 20: 283–292.CrossRefGoogle ScholarPubMed
6.Fox, J.Familial intracranial aneurysms. J Neurosurg 1980; 57: 416–417.CrossRefGoogle Scholar
7.Mellgard, P., Ljunggren, B., Brandt, L., Johnson, U., Holtas, S.HLAtyping in a family with six intracranial aneurysms. Br J Neurosurg 1989; 3: 479–486.CrossRefGoogle Scholar
8.Patrick, D., Appleby, A.Familial intracranial aneurysm and infundibular widening. Neuroradiology 1983; 25: 329–334.CrossRefGoogle ScholarPubMed
9.Halal, F., Mohr, G., Toussi, T., Martinez, N.Intracranial aneurysms: a report of a large pedigree. Am J Med Genetic 1983; 15: 89–95.CrossRefGoogle ScholarPubMed
10.Edelsohn, L., Caplan, L., Rosenbaum, A.Familial aneurysms and infundibular widening. Neurology 1972; 22: 1056–1060.CrossRefGoogle ScholarPubMed
11.Evans, T., Venning, M., Strang, F., Donnai, D.Dominant inheritance of intracranial berry aneurysm. Br Med J 1981; 283: 824–825.CrossRefGoogle ScholarPubMed
12.Leblanc, R., Lozano, A., van der Rest, M., Guttmann, D.Absence of collagen deficiency in familial cerebral aneurysms. J Neurosurg 1989; 70: 837–840.CrossRefGoogle ScholarPubMed
13.Sahs, A., Perret, G., Locksley, H., Nishioka, H., Skultety, F.Preliminary remarks on subarachnoid hemorrhage. J Neurosurg 1966; 24: 782–788.CrossRefGoogle ScholarPubMed
14.Richardson, J., Hyland, H.Intracranial aneurysms. A clinical and pathological study of subarachnoid and intracerebral hemorrhage caused by berry aneurysms. Medicine 1941; 20: 1–83.CrossRefGoogle Scholar
15.Chason, J., Hindman, W.Berry aneurysms of the circle of Willis; results of a planned autopsy study. Neurology 1958; 8: 41–44.CrossRefGoogle ScholarPubMed
16.Ronkainen, A., Hernesniemi, J., Ryynanen, M.Familial subarachnoid hemorrhage in East Finland, 1977–1990. Neurosurgery 1993; 33: 787–797.Google ScholarPubMed
17.Ronkainen, A., Hernesniemi, J., Ryynanen, M., Puranen, M., Kuivaniemi, H.A ten percent prevalence of asymptomatic familial intracranial aneurysms: preliminary report on 110 magnetic resonance angiography studies in members of 21 Finnish familial intracranial aneurysm families. Neurosurgery 1994; 35: 208–213.CrossRefGoogle Scholar
18.Locksley, H.Natural history of subarachnoid hemorrhage, intracranial aneurysms and arteriovenous malformations. In: Sahs, A., Perret, G., Locksley, H., et al., eds. Intracranial Aneurysms and Subarachnoid Hemorrhage: A Cooperative Study. Philadelphia: JB Lippincott, 1969: 37–108.Google Scholar
19.Andrews, R.Intracranial aneurysms: characteristics of aneurysms in siblings. N Engl J Med 1977; 297: 115.Google ScholarPubMed
20.Goate, A., Chartier-Harlin, C., Mullan, M., et al. Segregation of a missense mutation in the amyloid precursor protein gene with familial Alzheimer’s disease. Nature 1991; 349: 704–706.CrossRefGoogle ScholarPubMed
21.Peltomaki, P., Aaltonen, L., Sistonen, P., et al. Genetic mapping of a locus predisposing to human colorectal cancer. Science 1993; 260: 810–812.CrossRefGoogle ScholarPubMed
22.Schievink, W., Limburg, M., Dreissen, J., Peeters, F., ter Berg, H.Screening for unruptured familial intracranial aneurysms: subarachnoid hemorrhage 2 years after angiography negative for aneurysms. Neurosurgery 1991; 29: 434–437.CrossRefGoogle ScholarPubMed
23.Sarwar, M., Batnitzky, S., Schechter, M., Liebeskind, A., Zimmer, A.Growing intracranial aneurysms. Radiology 1976; 120: 603–607.CrossRefGoogle ScholarPubMed
24.Allcock, J., Canham, P.Angiographic study of the growth of intracranial aneurysms. J Neurosurg 1976; 45: 617–621.CrossRefGoogle ScholarPubMed
25.Sekhar, L., Heros, R.Origin, growth and rupture of saccular aneurysms: a review. Neurosurgery 1981; 8: 248–260.CrossRefGoogle ScholarPubMed
26.Lozano, A., Leblanc, R.Cerebral aneurysms and polycystic kidney disease: a critical review. Can J Neurol Sci 1992; 19: 222–227.CrossRefGoogle ScholarPubMed