Risks and Benefits of Screening for Intracranial Aneurysms in First-Degree Relatives of Patients with Sporadic Subarachnoid Hemorrhage

The outcome of subarachnoid hemorrhage from a ruptured aneurysm remains poor, with a case fatality rate of 50 percent and a rate of functional dependence of 20 percent. 1 The risk of subarachnoid hemorrhage among first-degree relatives (parents, siblings, and children) of affected patients is three to seven times that in the general population. 2 , 3 Magnetic resonance angiography (MRA) has offered a noninvasive method of screening for intracranial aneurysms. The benefits and risks of screening and the associated costs have not been prospectively assessed for persons who have only one affected first-degree relative, although this important issue has recently been discussed. . . .