Familial aneurysmal risk-the figures.

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Aneurysm screening advised for relatives

Lifelong screening can be recommended for people with a strong family history of aneurysmal subarachnoid haemorrhage, a Dutch study shows.

There are no formal screening recommendations for family members of those affected by the devastating condition, but the University Medical Center Utrecht has been running an informal program since 1993.

Five-yearly MRI scans are offered from age 18 for people with two or more affected first-degree relatives.

Publishing their findings last month, researchers showed that the yield from screening remains substantial even after a decade of follow-up.

Aneurysms were detected in 51 of 458 (11%) of people at the initial screen and 21 of 261 (8%) at the five-year screen. At 10- and 15-year screening, the yield was 5%.

However, the risk was still not completely eliminated: three patients developed subarachnoid haemorrhage, two of whom had known aneurysms and one with a de novo aneurysm that ruptured three years after her first screen.

"The key message that can be taken from this study is that it is reasonable to offer screening to the relatives of patients in whom two first-degree family members have had an aneurysmal subarachnoid haemorrhage ... provided proper pre-screening counselling is done and relatives fully understand the consequences and effect that the discovery of an aneurysm might have on their life," an accompanying editorial said.

Around 2000 Australians are known to experience subarachnoid haemorrhage every year — an incidence of 10.3 per 100,000 person-years.

Lancet Neurology 2014; online.