Subarachnoid hemorrhage screening: Difference between revisions
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===Time of screening=== | ===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> | 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 | *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> | 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 ADPKD most often occurs before the age of 50 and in patients with poorly controlled hypertension | *Aneurysm rupture in [[Polycystic kidney disease|ADPKD]] most often occurs before the age of 50 and in patients with poorly controlled [[hypertension]] | ||
===Screening test=== | ===Screening test=== | ||
*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> | *[[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> | ||
*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> | *[[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== | ||
Revision as of 17:29, 8 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: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Screening
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.[1][2] This risk of aneurysm is also influenced by other risk factors such as cigarette smoking and hypertension.[3] 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.[4][5]
- Screening is not recommend in individuals with only one affected first-degree relative.[6]
Heritable conditions
Time of screening
Familiar:[1]
- 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 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.
- ↑ 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.
- ↑ Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage http://stroke.ahajournals.org/content/early/2012/05/03/STR.0b013e3182587839
- ↑ Schievink WI (1997). "Intracranial aneurysms". N Engl J Med. 336 (1): 28–40. doi:10.1056/NEJM199701023360106. PMID 8970938.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.