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Aneurysms were found in 25 of 625 first-degree relatives (4.0 percent; 95 percent confidence interval, 2.6 to 5.8 percent). Eighteen underwent surgery, which resulted in a decrease in function in 11 (disabling in 1). Five had medium-size d aneurysms that were 5 to 11 mm in diameter, 11 had small aneurysms that were less than 5 mm, and 2 had both small and medium-sized aneurysms. On average, surgery increased estimated life expectancy by 2.5 years for those 18 subjects (or by .9 month per person screened), at the expense of 19 years of decreased function per person. The number of relatives who would need to be screened in order to prevent 1 subarachnoid hemorrhage on a lifetime basis was 149, and 298 would have to be screened in order to prevent 1 fatal subarachnoid hemorrhage. Implementation of a screening program for the first-degree relatives of patients with sporadic subarachnoid hemorrhage does not seem warranted at this time, since the resulting slight increase in life expectancy does not offset the risk of postoperative sequelae. |
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aneurysm
aneurysm,asymptomatic
aneurysm,intracranial
aneurysm,intracranial,familial
aneurysm,intracranial,screening for
aneurysm,unruptured
controversies in neurology
familial
MRI
MRI,angiography
risk-benefit assessment
subarachnoid hemorrhage
subarachnoid hemorrhage,familial
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