From the Departments of Neurosurgery (A.R., J.H.), Medicine (H.M.),
Pathology and Forensic Medicine (K.K., S.P.), and Clinical Radiology (R.V.,
M.P.), Kuopio University Hospital (Finland).
Correspondence to Antti Ronkainen, MD, PhD, Department of Neurosurgery, Kuopio University Hospital, PO Box 1777, FIN-70210 Kuopio, Finland. E-mail antti.ronkainen{at}kuh.fi
Background and Purpose—The
purpose of the present study was to calculate the prevalence and
relative risk of unruptured incidental intracranial aneurysms
(IAs) among families with IA case(s) compared with the general
population in one geographically defined area in East Finland and to
identify the risk group that could benefit most from screening for IAs.
We compared these results with our earlier study results of familial IA
(FIA) cases, with two or more known IA cases in the same
family.
Methods—The study groups were collected from the catchment
area of the University Hospital of Kuopio in East Finland. The
inclusion criteria were age 30 to 70 years and unruptured incidental
IAs
Results—The relative risk for IAs among first-degree
relatives in FIA families was 4.2 (95% confidence interval, 2.2 to
8.0) and among first-degree relatives in families with only one
affected family member was 1.8 (95% confidence interval, 0.7 to 4.8)
compared with the general population in East Finland.
Conclusions—First-degree relatives in FIA families constitute a
high-risk group for incidental IAs, and this group would benefit from
screening studies for IAs. Screening for IAs in families with only one
affected member or in the general population is not recommended.
© 1998 American Heart Association, Inc.
Original Contributions
Risk of Harboring an Unruptured Intracranial Aneurysm
3 mm. Patients with previous subarachnoid
hemorrhage or in whom a ruptured IA was found to be the cause
of death were excluded from all study groups. During routine forensic
autopsies the circle of Willis was studied for IAs to estimate the
number of IAs in the general population. In the families with one known
IA case and in FIA families, MR angiography was used as a preliminary
screening method for IAs, followed by intra-arterial
angiography to verify suspected IAs. Study populations were age and sex
adjusted for the statistical calculations.
Key Words: angiography, magnetic resonance • cerebral aneurysm, familial • prevalence • prevention • risk • screening
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