[Intracranial aneurysms and autosomal dominant polycystic kidney disease]

The implementation of a screening program for first degree relatives of patients with sporadic subarachnoid hemorrhage by means of magnetic resonance angiography does not seem to be warranted, since the resulting increase in life expectancy does not offset the risk of postoperative sequelae. Some exceptions, however, should be considered. We present a family suffering from autosomal dominant polycystic kidney disease. Two of the four siblings had a subarachnoid hemorrhage from an aneurysm of a cerebral artery. Although intracranial aneurysms are accepted as extrarenal manifestations of autosomal dominant polycystic kidney disease, the exact frequency of the association is unknown. Nevertheless, the maximum rate of coincidence dealt with in the literature is 41 percent. Because of this high association every patient suffering from a subarachnoid hemorrhage due to an intracranial aneurysm should be screened by an abdominal ultrasound. In case of an association first degree relatives should be examined for a polycystic kidney disease and in the case of a positive result a magnetic resonance angiography of the intracranial vessels should be performed.