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Concordant symptomatic intracranial aneurysm in a monozygotic twin: a case report and review of the literature.
Twin Res Hum Genet. 2009 Jun; 12(3):295-300.TR

Abstract

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.

Authors+Show Affiliations

Department of Neurosurgery, University Medical Center Groningen, University of Groningen, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

19456222

Citation

ter Laan, Mark, et al. "Concordant Symptomatic Intracranial Aneurysm in a Monozygotic Twin: a Case Report and Review of the Literature." Twin Research and Human Genetics : the Official Journal of the International Society for Twin Studies, vol. 12, no. 3, 2009, pp. 295-300.
ter Laan M, Kerstjens-Frederikse WS, Metzemaekers JD, et al. Concordant symptomatic intracranial aneurysm in a monozygotic twin: a case report and review of the literature. Twin Res Hum Genet. 2009;12(3):295-300.
ter Laan, M., Kerstjens-Frederikse, W. S., Metzemaekers, J. D., van Dijk, J. M., & Groen, R. J. (2009). Concordant symptomatic intracranial aneurysm in a monozygotic twin: a case report and review of the literature. Twin Research and Human Genetics : the Official Journal of the International Society for Twin Studies, 12(3), 295-300. https://doi.org/10.1375/twin.12.3.295
ter Laan M, et al. Concordant Symptomatic Intracranial Aneurysm in a Monozygotic Twin: a Case Report and Review of the Literature. Twin Res Hum Genet. 2009;12(3):295-300. PubMed PMID: 19456222.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Concordant symptomatic intracranial aneurysm in a monozygotic twin: a case report and review of the literature. AU - ter Laan,Mark, AU - Kerstjens-Frederikse,Wilhelmina S, AU - Metzemaekers,Jan D M, AU - van Dijk,J Marc C, AU - Groen,Rob J M, PY - 2009/5/22/entrez PY - 2009/5/22/pubmed PY - 2009/8/29/medline SP - 295 EP - 300 JF - Twin research and human genetics : the official journal of the International Society for Twin Studies JO - Twin Res Hum Genet VL - 12 IS - 3 N2 - 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. SN - 1832-4274 UR - https://www.unboundmedicine.com/medline/citation/19456222/Concordant_symptomatic_intracranial_aneurysm_in_a_monozygotic_twin:_a_case_report_and_review_of_the_literature_ L2 - https://www.cambridge.org/core/product/identifier/S1832427400009889/type/journal_article DB - PRIME DP - Unbound Medicine ER -