Question: My brother had a brain aneurysm at 18 months, my mother had an abdominal aortic aneurysm at 65, and my uncle has had three surgeries for blockages in his abdomen and leg. Does this run in families?
Dr. Hibberd's Answer:
The answer is YES. Single events such as you describe are not necessarily a sign that family screening is required, but I prefer to recommend it.
While it is true that cerebral (brain) aneurysms may be genetically determined, their expression may skip several generations, so screening all siblings and offspring randomly is usually nonproductive and may become cost-prohibitive in patients who have no symptoms. If you have concerns, see your doctor for an MRI/MRA consideration. If your risk is justifiable, you should be able to obtain insurance approval.
Abdominal aortic aneurysms also have a familial tendency, and ultrasound screening here is cost-effective. It is usually recommended starting as early as age 40, but certainly after the age of 60.
Blockages of aorta and peripheral arteries are more associated with smoking and underlying disease such as hypertension, diabetes, and hyperlipidemia. Though there may be a familial component, the largest contributors to this are lack of preventive care and smoking cigarettes.
These conditions are easily screened for by your doctor during your physical examination and will usually be detected with adverse ankle/brachial ratios. Ask your doctor to have this ratio performed for you if you have any concerns.
Ultrasound is usually reserved for high-risk patients, those with adverse physical findings, or those with adverse screening ratios. Contrasted CAT scan angiography and MRI investigations are usually reserved for symptomatic patients with adverse initial screening that may need minimally invasive or invasive surgical management.
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