2015年6月3日星期三

Brain Aneurysm in PKD: Symptoms, Diagnosis, and Prognosis

Brain aneurysm is potentially the most serious complication of Polycystic Kidney Disease. Approximately 10%~15% of people with adult PKD have a cerebral aneurysm in the area of the cerebral blood vessels. This condition increases with age in patients with the kidney disease. Continue reading to learn more about this complication.

Definition

An aneurysm refers to the section of an artery that has enlarged or "ballooned out." A brain aneurysm develops as there is a weakness in the wall of that artery. The weakness is either there at birth or it developed. People with PKD are at a higher risk for developing this condition.

Symptoms

Since often these aneurysms are asymptomatic until they rupture, causing severe neurologic problems as well as possibly being fatal. Due to their weakened walls, brain aneurysms can acutely rupture, causing massive hemorrhage that may lead to death.The presence of associated high blood pressure from PKD increases the likelihood of aneurysm rupture, as does a prior family history of aneurysm rupture.

Diagnosis

CT (computerized tomography). This can be ordered when patients experience an acute onset of the worst headache of the patient's life associated with a stiff neck and an ill-appearing patient on physical examination. More than 90% of cases will show a subarachnoid hemorrhage.

LP (lumbar puncture). It is done in few cases when a CT fail to recognized the condition.

Angiography. This is performed to identify the location of aneurysm and to plan treatment. New technology allows angiography to be done in association with CT or MRI (magnetic resonance imaging).

Prognosis


Brain aneurysms are deadly. About 10% of patient with a ruptured aneurysm die before receiving medical care. Untreated, 50% will die within a month, with 25% sustaining another bleeding episode in a week. Moreover, there is significant risk of artery spasm leading to stroke.

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