Nakagawa T, Hashi K, Kurokawa Y, Yamamura A
ShinSapporo Neurosurgical Hospital, and Department of Neurosurgery, Sapporo Medical University School of Medicine, Japan.
J Neurosurg. 1999 Sep;91(3):391-5. doi: 10.3171/jns.1999.91.3.0391.
Previously the authors reported a significant correlation between a family history of subarachnoid hemorrhage (SAH) and the discovery of an unruptured aneurysm in a group of healthy volunteers. This study corroborates and extends previous findings regarding the relationship between genetic and acquired factors in the formation of cerebral aneurysms.
The incidence of asymptomatic, unruptured cerebral aneurysms was studied among patients with a family history of SAH within the second degree of consanguinity. Forty-one unruptured cerebral aneurysms were found in 34 (13.9%) of 244 patients. This incidence was significantly higher than that found in a control group of healthy volunteers (6%). Furthermore, patients who had a family history of SAH combined with multiple systemic risk factors were found to have the highest incidence of unruptured aneurysms (32%; odds ratio 3.49, 95% confidence interval 1.37-8.9).
These findings suggest that patients with a family history of SAH with or without the presence of more than one systemic risk factor are at significantly higher risk of harboring cerebral aneurysms. This high-risk group should be periodically screened and treated with appropriate surgical or other forms of therapy when necessary.
此前作者报道在一组健康志愿者中，蛛网膜下腔出血（SAH）家族史与未破裂动脉瘤的发现之间存在显著相关性。本研究证实并扩展了先前关于脑动脉瘤形成中遗传因素与后天因素之间关系的研究结果。
对二级血缘关系内有SAH家族史的患者中无症状、未破裂脑动脉瘤的发病率进行了研究。在244例患者中的34例（13.9%）发现了41个未破裂脑动脉瘤。该发病率显著高于健康志愿者对照组（6%）。此外，发现有SAH家族史并伴有多种全身危险因素的患者未破裂动脉瘤的发病率最高（32%；比值比3.49，95%置信区间1.37 - 8.9）。
这些发现表明，有或没有多种全身危险因素的SAH家族史患者患脑动脉瘤的风险显著更高。这一高危人群应定期进行筛查，并在必要时接受适当的手术或其他形式的治疗。
