Document Detail

Concordant symptomatic intracranial aneurysm in a monozygotic twin: a case report and review of the literature.
MedLine Citation:
PMID:  19456222     Owner:  NLM     Status:  MEDLINE    
The development of an intracranial aneurysm (IA) is a multifactorial process, involving genetic and environmental factors. The presence of IA or aneurysmal subarachnoid hemorrhage (aSAH) in twins is particularly interesting, since both genetic and environmental factors can be studied. It also raises the question of whether, when one twin is affected, the other asymptomatic twin should be examined for an IA. We report on a monozygotic (MZ) twin-pair with aSAH in both twins and we review all reported cases of IA in MZ twins. Including our case, we found only 14 MZ twin-pairs in which both twins harbored an IA, suggesting a heavy underreporting in the medical literature. In this small group, a high concordance was noted in the sites of IAs. In MZ twins, the preferred sites for IAs are the branching arteries, while aneurysms arising from fusion arteries are rare. These sites differ from the preferential sites seen in series of familial IAs and series of sporadic IAs. We therefore hypothesize that the twinning process might play a significant role in the development of IAs in MZ twins. To further explore and substantiate this, the large twin registries should be studied. Although IAs in MZ twins with a negative family history for IAs should not be regarded as familial IAs, screening of the asymptomatic twin should be seriously considered if one MZ twin presents with an aSAH or an IA, because of the high fatality rates reported in asymptomatic (and not screened) MZ twin-halves.
Mark ter Laan; Wilhelmina S Kerstjens-Frederikse; Jan D M Metzemaekers; J Marc C van Dijk; Rob J M Groen
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Twin research and human genetics : the official journal of the International Society for Twin Studies     Volume:  12     ISSN:  1832-4274     ISO Abbreviation:  -     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-21     Completed Date:  2009-08-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101244624     Medline TA:  Twin Res Hum Genet     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  295-300     Citation Subset:  IM    
Department of Neurosurgery, University Medical Center Groningen, University of Groningen, The Netherlands.
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MeSH Terms
Diseases in Twins / diagnosis*,  pathology
Intracranial Aneurysm / diagnosis*,  pathology
Middle Aged
Subarachnoid Hemorrhage / pathology
Twins, Monozygotic*

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