Clinical features of intracranial aneurysms in siblings.
OBJECTIVE
Among the family members of patients with aneurysmal subarachnoid hemorrhage (SAH), siblings have been documented to be at high risk of SAH and to have a high prevalence of unruptured aneurysms. We studied the distinctive features of aneurysms in siblings and attempted to determine the risk of rupture.


METHODS
We analyzed detailed data on 159 patients with siblings who had ruptured and unruptured aneurysms in 77 families from throughout Japan.


RESULTS
Seventy-three percent of the patients were female, and the mean age at the time of rupture was 55.6 years. In 39 families, two or more siblings had SAH. Eighty of 107 patients with ruptured aneurysms and 28 of 52 with unruptured aneurysms had a family history of SAH in siblings (P = 0.0082). Multiple and mirror-image aneurysms were found in 42 and 21 patients, respectively. Among 218 aneurysms, middle cerebral artery aneurysms were the most common type (43%). Anterior communicating artery aneurysms were underrepresented (15%). There were significantly more ruptured than unruptured anterior communicating artery aneurysms, compared with other aneurysms (P = 0.01).


CONCLUSIONS
The clinical features of aneurysms in siblings in this population agreed well with those reported for familial intracranial aneurysms and SAH, except for the age at the time of rupture. It is suggested that the risk of rupture is greater when patients with unruptured aneurysms have siblings with aneurysmal SAH and/or anterior communicating artery aneurysms.
Kasuya
H
H
Department of Neurosurgery, Tokyo Women's Medical University, Japan. hkasuya@nij.twmu.ac.jp
Onda
H
H
Takeshita
M
M
Hori
T
T
Takakura
K
K
D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000235:genetics* / Q000601:surgery; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000235:genetics* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012306:Risk; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000235:genetics* / Q000601:surgery