title: Systemic connective tissue abnormalities in patients with saccular intracranial aneurysms.
abstract: OBJECTIVE
  Our purpose was to identify the incidence and significance of markers of systemic connective tissue abnormalities (CTA) in patients with saccular intracranial aneurysms (SIA).
  
  
  METHODS
  This prospective case-control study included 199 consecutive patients with SIA (103 women and 96 men, mean age - 43.2 years) and 194 control patients - blood donors (108 - men, 86 - women, mean age - 38.4 years). Aneurysms were verified by conventional cerebral angiography. All patients were examined by the first author using a specially designed questionnaire and a standardized physical examination with special emphasis on systemic CTA.
  
  
  RESULTS
  Twelve markers of systemic CTA were significantly higher in patients with SIA than in controls: visible vessels on face and chest (59.8%), scoliosis (44.7%), varicose veins in legs (39.7%), flatfoot (34.6%), hyperextensibility of the skin (33.6%), spontaneous epistaxis (25.6%), easy bruising (20.6%), abdominal hernia (13.6%), periodontal disease (10.5%), chest deformations (7.5%), abdominal striae (3.5%), joint hypermobility (2.5%). A blinded validation study in a subset of 43 patients showed similar results. Among patients with SIA, 125 of 199 patients (62.8%) had at least three markers of systemic CTA compared with 23 (11.8%) of the controls (P < 0.0001, OR = 12.5, 95% CI 7.45-21.1). The mean number of markers of systemic CTA in patients with SIA was 3.07 and 1.17 in controls.
  
  
  CONCLUSIONS
  Patients with SIA have multiple markers of systemic connective tissue abnormalities. Systemic weakness of connective tissue represents a risk factor for development of SIA. Identification of these markers may help in detection of high-risk patients.
authors: Department of Urgent Neurology, The Urals State Medical Academy, Yekaterinburg, Russia. cosmos@k66.ru
authors: E R
authors: ER
authors: Lebedeva
authors: V P
authors: VP
authors: Sakovich
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002533:Cerebral Angiography; D003238:Connective Tissue / Q000000981:diagnostic imaging / Q000473:pathology*; D003240:Connective Tissue Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012189:Retrospective Studies; D012444:Saccule and Utricle / Q000473:pathology; D055815:Young Adult
keywords: connective tissue; intracranial aneurysms; markers; risk factors