Characteristics of the ruptured intracranial cerebral aneurysms in patients with autosomal dominant polycystic kidney disease (ADPKD) and review of literature

Abstract

Objective: This study was performed to examine the characteristics of the ruptured intracranial cerebral aneurysms in patients with autosomal dominant polycystic kidney disease (ADPKD) in a single institute and review of the past reports. Patients and methods: We reviewed the cases of ruptured cerebral aneurysm in ADPKD patients from January 2000 to December 2016 in our institute. We extracted patient’s demographics (patient age and sex), the sites of cerebral aneurysms and their sizes, Hunt and Kosnik grades at the onset, their medical history (hypertension and hemodialysis), familial history of subarachnoid hemorrhage (SAH), surgical procedures, and modified Rankin Scale (mRS) at 3 months after onsets. In addition, we reviewed our data compared to the reports associated with ruptured intracranial cerebral aneurysms in patients with ADPKD. Results: The tendency of SAH of ADPKD patients was estimated that the onset average age of SAH was around 30–40, female dominant, predilection sites (middle cerebral artery (MCA) and anterior communicating artery (A-Com)), small aneurysm size (under 5 mm), many having hypertension as past medical history, and favoured neck clipping for ruptured aneurysms. The tendency was estimated from the data. Conclusion: Most of ruptured cerebral aneurysms in ADPKD patients were small and located in the anterior circulation. The rate of repeat SAH was high, considered that patients were given regular follow-up by magnetic resonance angiography (MRA).

Keywords

• Ruptured intracranial cerebral aneurysm
• Autosomal dominant polycystic kidney disease (ADPDK)
• Review