2016年9月19日星期一

Multiple Intracranial Aneurysm of Polycystic Kidney Disease

Multiple Intracranial Aneurysm (MIA) which may gradually develop into rupture and bleeding is rarely seen among Polycystic Kidney Disease patients. Previously, the incidence of MIA is quite different to each report, which is related with emphasis degree and examination methods. With the application of CT technology, many smaller aneurysms with diameter less than 3mm are found. According to the research of 266 Polycystic Kidney Disease patients, 8% patients have MIA without any related symptoms, and 14% patients have intracranial aneurysm with diameter more than 6mm. Rupture rate of intracranial aneurysm among Polycystic Kidney Disease patients is not sure. It had been reported that the incidence of it may be 1/2000 per year, and each patient who is older than 30 years old have an incidence of 1/1000 per year, with higher death rate than End Stage Renal Failure patients caused by Polycystic Kidney Disease.

Intracranial Aneurysm should be treated in order to prevent a secondary bleeding and cerebral ischemia. Both medicine and surgical operation can be taken to treat intracranial aneurysm. As for patients who suffer from headache, Codeine can be taken, but Aspirin is forbidden. More than 25% patients get cerebral ischemia 5 to 14 days after aneurysm rupture. At this moment, vasoactive drugs and calcium antagonist can be used properly. Surgical operation should be taken as early as possible and 72 hours after bleeding is considered as the best period, because nearly 35% patients may have the possibility to get a secondary bleeding.

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