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PAW15 Screening patients with a family history of subarachnoid haemorrhage for intracranial aneurysms: screening uptake, patient characteristics and outcome
  1. T Miller,
  2. R Al-Shahi Salman,
  3. R J Davenport,
  4. P M White
  1. Division of Clinical Neuroscience, Western General Hospital, Edinburgh, UK
  1. Correspondence to thomasmiller{at}doctors.org.uk

Abstract

Background People with ≥1 first degree relative affected (FDRA) by aneurismal subarachnoid haemorrhage (SAH) are at higher lifetime risk of SAH than those without a family history. Screening may be worthwhile for people with ≥2 FDRA by aneurismal SAH, but its clinical effectiveness is not established beyond doubt.

Methods We performed a retrospective, observational analysis of consecutive attendances at an aneurysm screening clinic between October 2006 and June 2009.

Results Of 96 adults seen, 77 had ≥1 FDRA: 35 had ≥2 FDRA, 21 had 1 FDRA plus ≥1 affected second degree relative, and 21 had 1 FDRA only. In these three respective groups, 29 (83%), 15 (71%) and 5 (24%) adults underwent screening (p<0.0001), of whom 6 (21%), 3 (20%) and 1 (20%) had an aneurysm detected (p=1.0). Of the 10 patients with aneurysms, four underwent treatment. Considering other risk factors adults with ≥2 FDRA were more likely to be hypertensive (OR 4.1, 95% CI 1.2 to 13.4) but no more likely to smoke or drink to excess than adults with 1 FDRA. Adults who underwent screening were more likely to be hypertensive and drink alcohol to excess (both p<0.0001) but not more likely to smoke than those who were not screened.

Conclusion In clinical practice, aneurysm screening uptake increases with number of relatives affected by SAH and is associated with modifiable risk factors for SAH.

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