02686nas a2200325   4500000000100000008004100001100001700042700001500059700001100074700001500085700001900100700001600119700001600135700001400151700001400165700001400179700001500193700001400208700001600222700001800238700001700256700001900273700001900292245018700311250001500498300000900513490000800522520178400530020004602314       2012                            d1 aSauerbeck L.1 aHornung R.1 aWoo D.1 aRouleau G.1 aKleindorfer D.1 aFlaherty M.1 aMeissner I.1 aMackey J.1 aMoomaw C.1 aGandhi D.1 aKallmes D.1 aTorner J.1 aBrown R. Jr1 aHuston J. III1 aBroderick J.1 aAnderson Craig1 aConnolly E. Jr00aUnruptured intracranial aneurysms in the Familial Intracranial Aneurysm and International Study of Unruptured Intracranial Aneurysms cohorts: differences in multiplicity and location  a2012/05/01  a60-40 v1173 a<p>
Object Familial predisposition is a recognized nonmodifiable risk factor for the formation and rupture of intracranial aneurysms (IAs). However, data regarding the characteristics of familial IAs are limited. The authors sought to describe familial IAs more fully, and to compare their characteristics with a large cohort of nonfamilial IAs. Methods The Familial Intracranial Aneurysm (FIA) study is a multicenter international study with the goal of identifying genetic and other risk factors for formation and rupture of IAs in a highly enriched population. The authors compared the FIA study cohort with the International Study of Unruptured Intracranial Aneurysms (ISUIA) cohort with regard to patient demographic data, IA location, and IA multiplicity. To improve comparability, all patients in the ISUIA who had a family history of IAs or subarachnoid hemorrhage were excluded, as well as all patients in both cohorts who had a ruptured IA prior to study entry. Results Of 983 patients enrolled in the FIA study with definite or probable IAs, 511 met the inclusion criteria for this analysis. Of the 4059 patients in the ISUIA study, 983 had a previous IA rupture and 657 of the remainder had a positive family history, leaving 2419 individuals in the analysis. Multiplicity was more common in the FIA patients (35.6% vs 27.9%, p &lt; 0.001). The FIA patients had a higher proportion of IAs located in the middle cerebral artery (28.6% vs 24.9%), whereas ISUIA patients had a higher proportion of posterior communicating artery IAs (13.7% vs 8.2%, p = 0.016). Conclusions Heritable structural vulnerability may account for differences in IA multiplicity and location. Important investigations into the underlying genetic mechanisms of IA formation are ongoing.
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