Korean J Cerebrovasc Surg.  2007 Sep;9(3):212-215.

Clinical Analysis of Patients with Ruptured Cerebral Aneurysms associated with Polycystic Kidney Disease

Affiliations
  • 1Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea. leejw@yumc.yonsei.ac.kr
  • 2Department of Neurosurgery, Il-San Hospital, Il-san, GyeongGi-Do, Republic of Korea.

Abstract


OBJECTIVE
This study is to define the clinical characteristics and formulate the management strategies of the patients with ruptured cerebral aneurysms associated with polycystic kidney diseases (PKD).
METHODS
During the past 30 years, among of 3,013 patients who were treated with intracranial aneurysms, 7 patients had ruptured cerebral aneurysms associated with PKD. The authors retrospectively reviewed the database and imaging studies of such patients as sources for identification and analysis.
RESULTS
All 7 patients presented with subarachnoid hemorrhage (SAH). One patient showed Hunt and Hess grade I, 4 of grade II, and 2 of grade III. Six patients showed Fisher group II and 1 patient of group III. Four aneurysms were located at anterior cerebral artery, 2 at middle cerebral artery, and 1 at internal carotid artery. Five patients had small aneurysms and the remaining 2 had large (diameter > or = 10 mm) aneurysms. All aneurysms were in saccular shape. Two of the 7 patients (28.6%) had multiple aneurysms. One patient suffered delayed ischemic neurological deficit. All patients were treated by microsurgery and showed favorable outcome (good: 7).
CONCLUSIONS
The patients harboring PKD had high probability of hypertension. So, intact aneurysms in those patients were exposed to higher rate of being ruptured. Surgery was necessary for ruptured lesions, as well as unruptured lesions which size was increased at follow up imaging study. Multimodality management approach with nephrologist and neuroradiologist are very necessary. The ultimate management outcome was satisfactory.

Keyword

Cerebral aneurysm; Polycystic kidney

MeSH Terms

Aneurysm
Anterior Cerebral Artery
Carotid Artery, Internal
Follow-Up Studies
Humans
Hypertension
Intracranial Aneurysm*
Microsurgery
Middle Cerebral Artery
Polycystic Kidney Diseases*
Retrospective Studies
Subarachnoid Hemorrhage
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