Subarachnoid hemorrhage screening: Difference between revisions
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{{Subarachnoid hemorrhage}} | {{Subarachnoid hemorrhage}} | ||
{{CMG}}; '''Associate Editor(s)-In-Chief:''' {{ | {{CMG}}; '''Associate Editor(s)-In-Chief:''' {{SaraM}} | ||
==Overview== | ==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.<ref name="pmid11056108">{{cite journal| author=Bederson JB, Awad IA, Wiebers DO, Piepgras D, Haley EC, Brott T et al.| title=Recommendations for the management of patients with unruptured intracranial aneurysms: A statement for healthcare professionals from the Stroke Council of the American Heart Association. | journal=Circulation | year= 2000 | volume= 102 | issue= 18 | pages= 2300-8 | pmid=11056108 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11056108 }} </ref><ref name="aSAH">Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage http://stroke.ahajournals.org/content/early/2012/05/03/STR.0b013e3182587839</ref> However, screening is not recommend in individuals with only one affected first-degree relative.<ref name="pmid8970938">{{cite journal| author=Schievink WI| title=Intracranial aneurysms. | journal=N Engl J Med | year= 1997 | volume= 336 | issue= 1 | pages= 28-40 | pmid=8970938 | doi=10.1056/NEJM199701023360106 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8970938 }} </ref> | |||
Additionally, screening is recommend in the patient with heritable conditions such as [[autosomal dominant polycystic kidney disease|Autosomal dominant polycystic kidney disease (ADPKD)]], [[Hyperaldosteronism|glucocorticoid remediable hyperaldosteronism (GRA)]], and [[Connective tissue disease|connective tissue diseases]]. <ref name="pmid10706896">{{cite journal| author=Pepin M, Schwarze U, Superti-Furga A, Byers PH| title=Clinical and genetic features of Ehlers-Danlos syndrome type IV, the vascular type. | journal=N Engl J Med | year= 2000 | volume= 342 | issue= 10 | pages= 673-80 | pmid=10706896 | doi=10.1056/NEJM200003093421001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10706896 }} </ref><ref name="pmid8007584">{{cite journal| author=Chauveau D, Pirson Y, Verellen-Dumoulin C, Macnicol A, Gonzalo A, Grünfeld JP| title=Intracranial aneurysms in autosomal dominant polycystic kidney disease. | journal=Kidney Int | year= 1994 | volume= 45 | issue= 4 | pages= 1140-6 | pmid=8007584 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8007584 }} </ref><ref name="pmid9453343">{{cite journal| author=Litchfield WR, Anderson BF, Weiss RJ, Lifton RP, Dluhy RG| title=Intracranial aneurysm and hemorrhagic stroke in glucocorticoid-remediable aldosteronism. | journal=Hypertension | year= 1998 | volume= 31 | issue= 1 Pt 2 | pages= 445-50 | pmid=9453343 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9453343 }} </ref> | |||
==Screening== | ==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 [[Aneurysm|aneurysms]] tend to rupture at a smaller size and younger age than sporadic [[Aneurysm|aneurysms]].<ref name="pmid9033463">{{cite journal| author=Ronkainen A, Hernesniemi J, Puranen M, Niemitukia L, Vanninen R, Ryynänen M et al.| title=Familial intracranial aneurysms. | journal=Lancet | year= 1997 | volume= 349 | issue= 9049 | pages= 380-4 | pmid=9033463 | doi=10.1016/S0140-6736(97)80009-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9033463 }} </ref><ref name="pmid10496256">{{cite journal| author=Raaymakers TW| title=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. | journal=Neurology | year= 1999 | volume= 53 | issue= 5 | pages= 982-8 | pmid=10496256 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10496256 }} </ref> | 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 [[Aneurysm|aneurysms]] tend to rupture at a smaller size and younger age than sporadic [[Aneurysm|aneurysms]].<ref name="pmid9033463">{{cite journal| author=Ronkainen A, Hernesniemi J, Puranen M, Niemitukia L, Vanninen R, Ryynänen M et al.| title=Familial intracranial aneurysms. | journal=Lancet | year= 1997 | volume= 349 | issue= 9049 | pages= 380-4 | pmid=9033463 | doi=10.1016/S0140-6736(97)80009-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9033463 }} </ref><ref name="pmid10496256">{{cite journal| author=Raaymakers TW| title=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. | journal=Neurology | year= 1999 | volume= 53 | issue= 5 | pages= 982-8 | pmid=10496256 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10496256 }} </ref> | ||
This risk of aneurysm is also influenced by other risk factors such as [[cigarette smoking]] and [[hypertension]].<ref name="pmid22423116">{{cite journal| author=Rasing I, Nieuwkamp DJ, Algra A, Rinkel GJ| title=Additional risk of hypertension and smoking for aneurysms in people with a family history of subarachnoid haemorrhage. | journal=J Neurol Neurosurg Psychiatry | year= 2012 | volume= 83 | issue= 5 | pages= 541-2 | pmid=22423116 | doi=10.1136/jnnp-2011-301147 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22423116 }} </ref> The mode of inheritance can be variable, with [[autosomal dominant]], [[Autosomal recessive|recessive]], and multifactorial transmission. | This risk of aneurysm is also influenced by other risk factors such as [[cigarette smoking]] and [[hypertension]].<ref name="pmid22423116">{{cite journal| author=Rasing I, Nieuwkamp DJ, Algra A, Rinkel GJ| title=Additional risk of hypertension and smoking for aneurysms in people with a family history of subarachnoid haemorrhage. | journal=J Neurol Neurosurg Psychiatry | year= 2012 | volume= 83 | issue= 5 | pages= 541-2 | pmid=22423116 | doi=10.1136/jnnp-2011-301147 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22423116 }} </ref> The mode of inheritance can be variable, with [[autosomal dominant]], [[Autosomal recessive|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.<ref name="pmid11056108">{{cite journal| author=Bederson JB, Awad IA, Wiebers DO, Piepgras D, Haley EC, Brott T et al.| title=Recommendations for the management of patients with unruptured intracranial aneurysms: A statement for healthcare professionals from the Stroke Council of the American Heart Association. | journal=Circulation | year= 2000 | volume= 102 | issue= 18 | pages= 2300-8 | pmid=11056108 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11056108 }} </ref> | *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.<ref name="pmid11056108">{{cite journal| author=Bederson JB, Awad IA, Wiebers DO, Piepgras D, Haley EC, Brott T et al.| title=Recommendations for the management of patients with unruptured intracranial aneurysms: A statement for healthcare professionals from the Stroke Council of the American Heart Association. | journal=Circulation | year= 2000 | volume= 102 | issue= 18 | pages= 2300-8 | pmid=11056108 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11056108 }} </ref><ref name="aSAH">Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage http://stroke.ahajournals.org/content/early/2012/05/03/STR.0b013e3182587839</ref> | ||
*Screening is not recommend in individuals with only one affected first-degree relative.<ref name="pmid8970938">{{cite journal| author=Schievink WI| title=Intracranial aneurysms. | journal=N Engl J Med | year= 1997 | volume= 336 | issue= 1 | pages= 28-40 | pmid=8970938 | doi=10.1056/NEJM199701023360106 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8970938 }} </ref> | *Screening is not recommend in individuals with only one affected first-degree relative.<ref name="pmid8970938">{{cite journal| author=Schievink WI| title=Intracranial aneurysms. | journal=N Engl J Med | year= 1997 | volume= 336 | issue= 1 | pages= 28-40 | pmid=8970938 | doi=10.1056/NEJM199701023360106 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8970938 }} </ref> | ||
===Heritable conditions=== | ===Heritable conditions screening=== | ||
*Screening is recommend in the patient with heritable conditions such as:<ref name="pmid10706896">{{cite journal| author=Pepin M, Schwarze U, Superti-Furga A, Byers PH| title=Clinical and genetic features of Ehlers-Danlos syndrome type IV, the vascular type. | journal=N Engl J Med | year= 2000 | volume= 342 | issue= 10 | pages= 673-80 | pmid=10706896 | doi=10.1056/NEJM200003093421001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10706896 }} </ref><ref name="pmid8007584">{{cite journal| author=Chauveau D, Pirson Y, Verellen-Dumoulin C, Macnicol A, Gonzalo A, Grünfeld JP| title=Intracranial aneurysms in autosomal dominant polycystic kidney disease. | journal=Kidney Int | year= 1994 | volume= 45 | issue= 4 | pages= 1140-6 | pmid=8007584 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8007584 }} </ref><ref name="pmid9453343">{{cite journal| author=Litchfield WR, Anderson BF, Weiss RJ, Lifton RP, Dluhy RG| title=Intracranial aneurysm and hemorrhagic stroke in glucocorticoid-remediable aldosteronism. | journal=Hypertension | year= 1998 | volume= 31 | issue= 1 Pt 2 | pages= 445-50 | pmid=9453343 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9453343 }} </ref> | *Screening is recommend in the patient with heritable conditions such as:<ref name="pmid10706896">{{cite journal| author=Pepin M, Schwarze U, Superti-Furga A, Byers PH| title=Clinical and genetic features of Ehlers-Danlos syndrome type IV, the vascular type. | journal=N Engl J Med | year= 2000 | volume= 342 | issue= 10 | pages= 673-80 | pmid=10706896 | doi=10.1056/NEJM200003093421001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10706896 }} </ref><ref name="pmid8007584">{{cite journal| author=Chauveau D, Pirson Y, Verellen-Dumoulin C, Macnicol A, Gonzalo A, Grünfeld JP| title=Intracranial aneurysms in autosomal dominant polycystic kidney disease. | journal=Kidney Int | year= 1994 | volume= 45 | issue= 4 | pages= 1140-6 | pmid=8007584 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8007584 }} </ref><ref name="pmid9453343">{{cite journal| author=Litchfield WR, Anderson BF, Weiss RJ, Lifton RP, Dluhy RG| title=Intracranial aneurysm and hemorrhagic stroke in glucocorticoid-remediable aldosteronism. | journal=Hypertension | year= 1998 | volume= 31 | issue= 1 Pt 2 | pages= 445-50 | pmid=9453343 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9453343 }} </ref> | ||
**[[Autosomal dominant polycystic kidney disease|Autosomal dominant polycystic kidney disease (ADPKD)]] | **[[Autosomal dominant polycystic kidney disease|Autosomal dominant polycystic kidney disease (ADPKD)]] | ||
| Line 19: | Line 21: | ||
*** [[Ehlers Danlos syndrome|Ehlers-Danlos syndrome IV]] | *** [[Ehlers Danlos syndrome|Ehlers-Danlos syndrome IV]] | ||
***[[Pseudoxanthoma elasticum]] | ***[[Pseudoxanthoma elasticum]] | ||
===Time of screening=== | |||
Familiar:<ref name="pmid9033463">{{cite journal| author=Ronkainen A, Hernesniemi J, Puranen M, Niemitukia L, Vanninen R, Ryynänen M et al.| title=Familial intracranial aneurysms. | journal=Lancet | year= 1997 | volume= 349 | issue= 9049 | pages= 380-4 | pmid=9033463 | doi=10.1016/S0140-6736(97)80009-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9033463 }} </ref> | |||
*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:<ref name="pmid1391712">{{cite journal| author=Schievink WI, Torres VE, Piepgras DG, Wiebers DO| title=Saccular intracranial aneurysms in autosomal dominant polycystic kidney disease. | journal=J Am Soc Nephrol | year= 1992 | volume= 3 | issue= 1 | pages= 88-95 | pmid=1391712 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1391712 }} </ref> | |||
*Aneurysm rupture in [[Polycystic kidney disease|ADPKD]] most often occurs before the age of 50 and in patients with poorly controlled [[hypertension]] | |||
===Screening test=== | |||
*[[Magnetic resonance angiography|MRA]] (identify aneurysms 3 to 5 mm or larger)<ref name="pmid7857409">{{cite journal| author=Huston J, Nichols DA, Luetmer PH, Goodwin JT, Meyer FB, Wiebers DO et al.| title=Blinded prospective evaluation of sensitivity of MR angiography to known intracranial aneurysms: importance of aneurysm size. | journal=AJNR Am J Neuroradiol | year= 1994 | volume= 15 | issue= 9 | pages= 1607-14 | pmid=7857409 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7857409 }} </ref><ref name="pmid8338918">{{cite journal| author=Huston J, Torres VE, Sulivan PP, Offord KP, Wiebers DO| title=Value of magnetic resonance angiography for the detection of intracranial aneurysms in autosomal dominant polycystic kidney disease. | journal=J Am Soc Nephrol | year= 1993 | volume= 3 | issue= 12 | pages= 1871-7 | pmid=8338918 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8338918 }} </ref><ref name="pmid10584784">{{cite journal| author=Raaymakers TW, Buys PC, Verbeeten B, Ramos LM, Witkamp TD, Hulsmans FJ et al.| title=MR angiography as a screening tool for intracranial aneurysms: feasibility, test characteristics, and interobserver agreement. | journal=AJR Am J Roentgenol | year= 1999 | volume= 173 | issue= 6 | pages= 1469-75 | pmid=10584784 | doi=10.2214/ajr.173.6.10584784 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10584784 }} </ref> | |||
*[[CT angiography|CTA]] (miss aneurysms smaller than 3 mm, also may have false positive results)<ref name="pmid12943576">{{cite journal| author=van Gelder JM| title=Computed tomographic angiography for detecting cerebral aneurysms: implications of aneurysm size distribution for the sensitivity, specificity, and likelihood ratios. | journal=Neurosurgery | year= 2003 | volume= 53 | issue= 3 | pages= 597-605; discussion 605-6 | pmid=12943576 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12943576 }} </ref> | |||
==References== | ==References== | ||
Latest revision as of 14:25, 13 December 2016
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Subarachnoid Hemorrhage Microchapters |
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Diagnosis |
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Treatment |
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AHA/ASA Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage (2012)
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Case Studies |
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Subarachnoid hemorrhage screening On the Web |
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American Roentgen Ray Society Images of Subarachnoid hemorrhage screening |
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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.