Screening for brain aneurysm in the Familial Intracranial Aneurysm study: frequency and predictors of lesion detection

J Neurosurg. 2008 Jun;108(6):1132-8. doi: 10.3171/JNS/2008/108/6/1132.


Object: 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.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Australia
  • Cohort Studies
  • Female
  • Genetic Predisposition to Disease
  • Humans
  • Intracranial Aneurysm / diagnosis*
  • Intracranial Aneurysm / epidemiology
  • Intracranial Aneurysm / genetics*
  • Magnetic Resonance Angiography
  • Male
  • Mass Screening
  • Middle Aged
  • New Zealand
  • North America
  • Predictive Value of Tests
  • Risk Factors