Headache as a manifestation of intracranial aneurysm in autosomal dominant polycystic kidney disease

Neurol Neurochir Pol. 2015;49(2):126-8. doi: 10.1016/j.pjnns.2015.02.002. Epub 2015 Feb 27.

Abstract

Background: Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder that affects 1 in 1.000 people in the general population, and is connected to increased risk for intracranial aneurysms (ICANs). In this work, we made an attempt to identify risk factors for subarachnoid hemorrhage (SAH) due to a rupture of an ICAN.

Methods: Retrospective analysis of series of cases including 8 ADPKD patients who passed a nonfatal stroke due to the rupture of an ICAN.

Results: The mean age at SAH was 40.13 years. In 88% of patients the renal function at SAH was normal. At least 63% of patients were hypertensive. The family history for ICAN and/or SAH was positive in 38% of patients, and in 63% of patients there were neurological symptoms preceding SAH, with headache as the most common one.

Conclusions: Similarly to ICAN and/or SAH in the family history, headache and/or other neurological symptoms should be indication for screening for ICANs in all ADPKD patients irrespectively of their age. We propose a set of criteria, which may enable detection of most cases of ICANs in ADPKD patients.

Keywords: Autosomal dominant polycystic kidney disease; Headache; Intracranial aneurysm; Risk factors; Subarachnoid hemorrhage.

MeSH terms

  • Adult
  • Aneurysm, Ruptured / complications
  • Female
  • Headache / etiology*
  • Humans
  • Intracranial Aneurysm / complications*
  • Intracranial Aneurysm / etiology*
  • Male
  • Middle Aged
  • Polycystic Kidney, Autosomal Dominant / complications*
  • Retrospective Studies
  • Risk Factors
  • Stroke / complications