Screening for brain aneurysm in the Familial Intracranial Aneurysm study: frequency and predictors of lesion detection.
OBJECTIVE
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.
Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA. brown@mayo.edu
Robert D
RD
Brown
John
J
Huston
Richard
R
Hornung
Tatiana
T
Foroud
David F
DF
Kallmes
Dawn
D
Kleindorfer
Irene
I
Meissner
Daniel
D
Woo
Laura
L
Sauerbeck
Joseph
J
Broderick
D000328:Adult; D000368:Aged; D001315:Australia; D015331:Cohort Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics*; D018810:Magnetic Resonance Angiography; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009520:New Zealand; D009656:North America; D011237:Predictive Value of Tests; D012307:Risk Factors