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Intracranial aneurysm screening: indications and advice for practice
1Department of Neurology, University Medical Centre, Utrecht, Netherlands. g.j.e.rinkel@neuro.azu.nl <g.j.e.rinkel@neuro.azu.nl>
The Lancet. Neurology
|January 25, 2005
Summary
Screening for intracranial aneurysms is recommended for individuals with a family history or polycystic kidney disease. Repeated screening may be necessary due to the high risk of new aneurysms developing over time.
Area of Science:
- Neurology
- Radiology
- Genetics
Background:
- Non-invasive imaging facilitates screening for intracranial aneurysms.
- Subarachnoid hemorrhage (SAH) is a serious condition often caused by ruptured aneurysms.
- Family history and polycystic kidney disease are significant risk factors for aneurysms.
Purpose of the Study:
- To identify individuals at risk for intracranial aneurysms.
- To evaluate the role of screening in managing aneurysm risk.
- To discuss the implications of screening for patients and healthcare providers.
Main Methods:
- Review of risk factors for intracranial aneurysms and SAH.
- Discussion of non-invasive imaging techniques for aneurysm screening.
- Analysis of the benefits and limitations of repeated screening.
Main Results:
- Positive family history (RR=6.6) and polycystic kidney disease (RR=4.4) are strong risk factors.
- Hypertension (RR=2.8) and smoking (RR=1.9) are common risk factors in the general population.
- High risk of new aneurysms exists even after negative initial screening.
Conclusions:
- Screening is most relevant for individuals with specific genetic predispositions or family history.
- The optimal interval and duration for repeated screening remain unclear.
- Physicians must discuss screening risks, benefits, and implications with patients before imaging.