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Familial Intracranial Aneurysms, A Review Stroke 23:1024-1030, terBerg,H.W.M.,et al, 1992 See this aricle in Pubmed Article Abstract No reliable data are available about the occurrence of familial intracranial aneurysms among all patients with ruptured aneurysms;a frequency of 6.7%has been reported from a retrospective study,but a large part of the"familial"occurrence can be explained by fortuitous aggregation.The pathogenesis of familial intracranial aneurysms is not fully explained;a(partial)deficiency of type III collagen has been reported in sporadic,but not in familial,cases.Clinical decision analysis shows how the risk of harboring an intracranial aneurysm and the age of the patient are the main determinants for elective screening;lifetime risk of rupture(and therefore age)and surgical risks are the determinants for neurosurgical treatment.Conclusions:Surgical treatment is recommended for patients aged<70 years with a moderate or low surgical risk,and screening (preferably by intra-arterial digital subtraction angiography)is recommended only for relatives aged 35-65 years.Magnetic resonance angiography may develop into a useful alternative for screening,but the risks of diagnostic procedures play only a minor role in the decision analysis.

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