Subarachnoid hemorrhage screening
|
Subarachnoid Hemorrhage Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
AHA/ASA Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage (2012)
|
|
Case Studies |
|
Subarachnoid hemorrhage screening On the Web |
|
American Roentgen Ray Society Images of Subarachnoid hemorrhage screening |
|
Risk calculators and risk factors for Subarachnoid hemorrhage screening |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Sara Mehrsefat, M.D. [2]
Overview
First-degree relatives screening is recommend in individuals with a positive family history of subarachnid hemorrhage or cerebral aneurysm in more than two family members.[1][2] However, screening is not recommend in individuals with only one affected first-degree relative.[3] Additionally, screening is recommend in the patient with heritable conditions such as Autosomal dominant polycystic kidney disease (ADPKD), glucocorticoid remediable hyperaldosteronism (GRA), and connective tissue diseases. [4][5][6]
Screening
First degree relatives screening
The risk of having subarachnoid hemorrhage (SAH) is much higher in individuals with a positive family history of first degree relatives with cerebral aneurysm compare to the general population and aneurysms tend to rupture at a smaller size and younger age than sporadic aneurysms.[7][8] This risk of aneurysm is also influenced by other risk factors such as cigarette smoking and hypertension.[9] The mode of inheritance can be variable, with autosomal dominant, recessive, and multifactorial transmission.
- First-degree relatives screening is recommend in individuals with a positive family history of subarachnid hemorrhage or cerebral aneurysm in more than two family members.[1][2]
- Screening is not recommend in individuals with only one affected first-degree relative.[3]
Heritable conditions screening
Time of screening
Familiar:[7]
- Siblings often experience rupture in the same decade of life. It is not likely that individuals develop SAH at younger ages than previous generations
Heritable:[10]
- Aneurysm rupture in ADPKD most often occurs before the age of 50 and in patients with poorly controlled hypertension
Screening test
- MRA (identify aneurysms 3 to 5 mm or larger)[11][12][13]
- CTA (miss aneurysms smaller than 3 mm, also may have false positive results)[14]
References
- ↑ 1.0 1.1 Bederson JB, Awad IA, Wiebers DO, Piepgras D, Haley EC, Brott T; et al. (2000). "Recommendations for the management of patients with unruptured intracranial aneurysms: A statement for healthcare professionals from the Stroke Council of the American Heart Association". Circulation. 102 (18): 2300–8. PMID 11056108.
- ↑ 2.0 2.1 Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage http://stroke.ahajournals.org/content/early/2012/05/03/STR.0b013e3182587839
- ↑ 3.0 3.1 Schievink WI (1997). "Intracranial aneurysms". N Engl J Med. 336 (1): 28–40. doi:10.1056/NEJM199701023360106. PMID 8970938.
- ↑ 4.0 4.1 Pepin M, Schwarze U, Superti-Furga A, Byers PH (2000). "Clinical and genetic features of Ehlers-Danlos syndrome type IV, the vascular type". N Engl J Med. 342 (10): 673–80. doi:10.1056/NEJM200003093421001. PMID 10706896.
- ↑ 5.0 5.1 Chauveau D, Pirson Y, Verellen-Dumoulin C, Macnicol A, Gonzalo A, Grünfeld JP (1994). "Intracranial aneurysms in autosomal dominant polycystic kidney disease". Kidney Int. 45 (4): 1140–6. PMID 8007584.
- ↑ 6.0 6.1 Litchfield WR, Anderson BF, Weiss RJ, Lifton RP, Dluhy RG (1998). "Intracranial aneurysm and hemorrhagic stroke in glucocorticoid-remediable aldosteronism". Hypertension. 31 (1 Pt 2): 445–50. PMID 9453343.
- ↑ 7.0 7.1 Ronkainen A, Hernesniemi J, Puranen M, Niemitukia L, Vanninen R, Ryynänen M; et al. (1997). "Familial intracranial aneurysms". Lancet. 349 (9049): 380–4. doi:10.1016/S0140-6736(97)80009-8. PMID 9033463.
- ↑ Raaymakers TW (1999). "Aneurysms in relatives of patients with subarachnoid hemorrhage: frequency and risk factors. MARS Study Group. Magnetic Resonance Angiography in Relatives of patients with Subarachnoid hemorrhage". Neurology. 53 (5): 982–8. PMID 10496256.
- ↑ Rasing I, Nieuwkamp DJ, Algra A, Rinkel GJ (2012). "Additional risk of hypertension and smoking for aneurysms in people with a family history of subarachnoid haemorrhage". J Neurol Neurosurg Psychiatry. 83 (5): 541–2. doi:10.1136/jnnp-2011-301147. PMID 22423116.
- ↑ Schievink WI, Torres VE, Piepgras DG, Wiebers DO (1992). "Saccular intracranial aneurysms in autosomal dominant polycystic kidney disease". J Am Soc Nephrol. 3 (1): 88–95. PMID 1391712.
- ↑ Huston J, Nichols DA, Luetmer PH, Goodwin JT, Meyer FB, Wiebers DO; et al. (1994). "Blinded prospective evaluation of sensitivity of MR angiography to known intracranial aneurysms: importance of aneurysm size". AJNR Am J Neuroradiol. 15 (9): 1607–14. PMID 7857409.
- ↑ Huston J, Torres VE, Sulivan PP, Offord KP, Wiebers DO (1993). "Value of magnetic resonance angiography for the detection of intracranial aneurysms in autosomal dominant polycystic kidney disease". J Am Soc Nephrol. 3 (12): 1871–7. PMID 8338918.
- ↑ Raaymakers TW, Buys PC, Verbeeten B, Ramos LM, Witkamp TD, Hulsmans FJ; et al. (1999). "MR angiography as a screening tool for intracranial aneurysms: feasibility, test characteristics, and interobserver agreement". AJR Am J Roentgenol. 173 (6): 1469–75. doi:10.2214/ajr.173.6.10584784. PMID 10584784.
- ↑ van Gelder JM (2003). "Computed tomographic angiography for detecting cerebral aneurysms: implications of aneurysm size distribution for the sensitivity, specificity, and likelihood ratios". Neurosurgery. 53 (3): 597–605, discussion 605-6. PMID 12943576.