The authors report seven individuals from two families, all of whom had aneurysmal subarachnoid hemorrhage These cases and all reported cases of familial aneurysms (243 aneurysms in 177 patients from 74 families) were submitted to computer-aided multivariate analysis to determine if the aneurysms or the patients who harbor them differ from sporadic aneurysm cases Familial aneurysms rupture at a smaller size (mean diameter 105 mm), and when the patient is younger (mean age 423 years and decennial age at peak incidence 40 to 49 years) There is a similar sex distribution (male to female ratio 48:52), a similar incidence of multiple aneurysms (215%), and a similar predominance of females over males with multiple aneurysms (22:1) Anterior communicating artery aneurysms occur less often in familial cases (19%) than in sporadic cases In sibling pairs the aneurysms occur at the same or at mirror sites, and rupture within the same decade twice as frequently as randomly selected nonfamilial aneurysm patient pairs The occurrence of aneurysms at identical and mirror sites is more frequent in familial cases and appears to be a function of the degree of kinship between affected individuals These observations suggest a genetic basis for the pathogenesis of familial intracranial aneurysms

Familial intracranial aneurysms.

Overall, supratentorial neurosurgical procedures are associated with a 17% risk of developing postoperative seizures. The incidence varies, but treatment of an arteriovenous malformation, an intracerebral haematoma, a middle cerebral artery aneurysm, an abscess, and meningiomas carry the highest risk. The role of prophylactic anticonvulsant therapy is discussed.

The incidence of postoperative seizures

The familial occurrence of intracranial aneurysms suggests the presence of a genetically determined underlying arteriopathy. The pattern of inheritance in these families usually is not known.A family with seven members with intracranial aneurysms is described and, from the literature before 1994, a total of 238 families with 560 affected members (56% female and 44% male) with intracranial aneurysms not associated with a known heritable disease are reviewed. A segregation analysis was performed on 73 of these families.Two members were affected in the great majority of families (79%); five or more members were reported in only eight families (3%). The most common affected kinship was among siblings. Angiographic screening in 12 families detected an intracranial aneurysm in 29% of 51 asymptomatic relatives. Segregation analysis revealed several patterns of inheritance that were consistent with the compiled pedigrees, but no single mendelian model was the overall best fitting, suggesting that genetic heteroge...

https://www.ahajournals.org/doi/pdf/10.1161/01.STR.25.10.2028

On the inheritance of intracranial aneurysms.

THE FAMILIAL OCCURRENCE of cerebral aneurysms in a defined clinical group of 1150 patients from a defined catchment area was studied. Two or more proven aneurysmal subarachnoid hemorrhage (SAH) patients within the same family were included. Of these 1150 patients, 113 (10%) had a proven familial occurrence of aneurysmal SAH. These 113 patients form 91 SAH families with a total of 203 aneurysm patients. Fifty-four percent of the patients were female, and the mean age in female patients was 49 years and in male patients was 44 years. In 23% of the families, three or more members were identified as having cerebral aneurysms. Middle cerebral artery aneurysms were the most common type (47%). Based on the high incidence (10%) of familial intracranial aneurysms among SAH patients, a prospective study of healthy family members for incidental intracranial aneurysms was performed, with positive findings of 12%.

Familial subarachnoid hemorrhage in east Finland, 1977-1990.

To delineate the distinctive features of familial subarachnoid hemorrhage, we compared gender and age at the time of subarachnoid hemorrhage, as well as site and number of aneurysms, in patients with familial subarachnoid hemorrhage (at least 1 first-degree relative with subarachnoid hemorrhage) and patients with sporadic subarachnoid hemorrhage (no subarachnoid hemorrhage in first- or second-degree relatives), in a prospective, hospital-based series of patients. In addition we studied the pattern of inheritance in 17 families with familial subarachnoid hemorrhage. Mean age at the time of hemorrhage in patients with the familial form was 6.8 years lower than that in those with the sporadic form, and middle cerebral artery aneurysms occurred more often in patients with familial disease. Sex distribution and number of aneurysms were similar in the two groups. Inheritance was compatible with autosomal dominant transmission in some families, and with autosomal recessive or multifactorial transmission in others. In our 5 families as well as in all 18 previously reported families with two affected generations, the age at the time of subarachnoid hemorrhage was invariably lower in later generations, which is suggestive of anticipation. We conclude that familial subarachnoid hemorrhage is a separate entity with occurrence at a young age, predilection for aneurysms of the middle cerebral artery, and variable modes of inheritance, including autosomal dominant inheritance with possible anticipation.

/pdf/familial-subarachnoid-hemorrhage-distinctive-features-and-57gxgttadk.pdf

Familial subarachnoid hemorrhage: distinctive features and patterns of inheritance.

Sao relatados 4 casos de aneurismas cerebrais que ocorreram em duas familias. A etiologia dos aneurismas intracranianos e discutida, principalmente no que se refere a ocorrencia de aneurismas dentro de uma mesma familia. A literatura pertinente e revista e sao tecidos comentarios sobre a validade estatistica dessa associacao.

/pdf/familiar-incidence-of-intracranial-aneurysms-report-of-four-2stkgjn5ti.pdf

Familiar incidence of intracranial aneurysms: report of four cases in two families

Apos revisao da literatura concernente ao emprego do iotalamato de metilglucamina (IMG) como contraste ventricular, os autores analisam a tecnica de execucao da ventriculografia e os resultados obtidos em serie de 54 pacientes. Ressaltam a qualidade das imagens obtidas e a baixa incidencia de reacoes e complicacoes diretamente ligadas ao uso do contraste, concluindo pela grande utilidade deste processo no diagnostico neurocirurgico.

https://www.scielo.br/pdf/anp/v30n2/02.pdf

Ventriculography with water soluble contrast media

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Familiar incidence of intracranial aneurysms: report of four cases in two families

Ventriculography with water soluble contrast media