One-quarter of patients with autosomal dominant polycystic kidney disease (ADPKD) have aneurysms at autopsy, and 2% to 8% of patients with aneurysms have ADPKD.[36]Schievink WI, Michels VV, Piepgras DG. Neurovascular manifestations of heritable connective tissue disorders. A review. Stroke. 1994 Apr;25(4):889-903.
http://www.ncbi.nlm.nih.gov/pubmed/8160237?tool=bestpractice.com
Individuals with ADPKD are potential candidates for aneurysm screening.[29]Rinkel GJ. Intracranial aneurysm screening: indications and advice for practice. Lancet Neurol. 2005 Feb;4(2):122-8.
http://www.ncbi.nlm.nih.gov/pubmed/15664544?tool=bestpractice.com
Because of the possible hereditary aspects of SAH, patients who have two or more first-degree relatives with SAH are potential candidates for aneurysm screening.[25]Thompson BG, Brown RD Jr, Amin-Hanjani S, et al. Guidelines for the management of patients with unruptured intracranial aneurysms: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015 Aug;46(8):2368-400.
https://www.doi.org/10.1161/STR.0000000000000070
http://www.ncbi.nlm.nih.gov/pubmed/26089327?tool=bestpractice.com
[29]Rinkel GJ. Intracranial aneurysm screening: indications and advice for practice. Lancet Neurol. 2005 Feb;4(2):122-8.
http://www.ncbi.nlm.nih.gov/pubmed/15664544?tool=bestpractice.com
[35]Etminan N, de Sousa DA, Tiseo C, et al. European Stroke Organisation (ESO) guidelines on management of unruptured intracranial aneurysms. Eur Stroke J. 2022 Sep;7(3):V.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9446328
http://www.ncbi.nlm.nih.gov/pubmed/36082246?tool=bestpractice.com
Hypertension should be corrected, as this is one of the most important modifiable risk factors.[26]Juvela S, Porras M, Poussa K. Natural history of unruptured intracranial aneurysms: probability of and risk factors for aneurysm rupture. J Neurosurg. 2000 Sep;93(3):379-87.
http://www.ncbi.nlm.nih.gov/pubmed/10969934?tool=bestpractice.com
[29]Rinkel GJ. Intracranial aneurysm screening: indications and advice for practice. Lancet Neurol. 2005 Feb;4(2):122-8.
http://www.ncbi.nlm.nih.gov/pubmed/15664544?tool=bestpractice.com
[30]Broderick JP, Viscoli CM, Brott T, et al; Hemorrhagic Stroke Project Investigators. Major risk factors for aneurysmal subarachnoid hemorrhage in the young are modifiable. Stroke. 2003 Jun;34(6):1375-81.
http://www.ncbi.nlm.nih.gov/pubmed/12764233?tool=bestpractice.com
[31]Feigin VL, Rinkel GJ, Lawes CM, et al. Risk factors for subarachnoid hemorrhage: an updated systematic review of epidemiological studies. Stroke. 2005 Dec;36(12):2773-80.
http://www.ncbi.nlm.nih.gov/pubmed/16282541?tool=bestpractice.com
[32]Juvela S. Prehemorrhage risk factors for fatal intracranial aneurysm rupture. Stroke. 2003 Aug;34(8):1852-7.
http://www.ncbi.nlm.nih.gov/pubmed/12829865?tool=bestpractice.com
[33]Qureshi AI, Suri MF, Yahia AM, et al. Risk factors for subarachnoid hemorrhage. Neurosurgery. 2001 Sep;49(3):607-12.
http://www.ncbi.nlm.nih.gov/pubmed/11523670?tool=bestpractice.com
[34]Teunissen LL, Rinkel GJ, Algra A, et al. Risk factors for subarachnoid hemorrhage: a systematic review. Stroke. 1996 Mar;27(3):544-9.
https://www.ahajournals.org/doi/10.1161/01.STR.27.3.544
http://www.ncbi.nlm.nih.gov/pubmed/8610327?tool=bestpractice.com
Smoking is another important modifiable risk factor.[26]Juvela S, Porras M, Poussa K. Natural history of unruptured intracranial aneurysms: probability of and risk factors for aneurysm rupture. J Neurosurg. 2000 Sep;93(3):379-87.
http://www.ncbi.nlm.nih.gov/pubmed/10969934?tool=bestpractice.com
[30]Broderick JP, Viscoli CM, Brott T, et al; Hemorrhagic Stroke Project Investigators. Major risk factors for aneurysmal subarachnoid hemorrhage in the young are modifiable. Stroke. 2003 Jun;34(6):1375-81.
http://www.ncbi.nlm.nih.gov/pubmed/12764233?tool=bestpractice.com
[31]Feigin VL, Rinkel GJ, Lawes CM, et al. Risk factors for subarachnoid hemorrhage: an updated systematic review of epidemiological studies. Stroke. 2005 Dec;36(12):2773-80.
http://www.ncbi.nlm.nih.gov/pubmed/16282541?tool=bestpractice.com
[32]Juvela S. Prehemorrhage risk factors for fatal intracranial aneurysm rupture. Stroke. 2003 Aug;34(8):1852-7.
http://www.ncbi.nlm.nih.gov/pubmed/12829865?tool=bestpractice.com
[33]Qureshi AI, Suri MF, Yahia AM, et al. Risk factors for subarachnoid hemorrhage. Neurosurgery. 2001 Sep;49(3):607-12.
http://www.ncbi.nlm.nih.gov/pubmed/11523670?tool=bestpractice.com
[34]Teunissen LL, Rinkel GJ, Algra A, et al. Risk factors for subarachnoid hemorrhage: a systematic review. Stroke. 1996 Mar;27(3):544-9.
https://www.ahajournals.org/doi/10.1161/01.STR.27.3.544
http://www.ncbi.nlm.nih.gov/pubmed/8610327?tool=bestpractice.com
All patients should be encouraged not to smoke.