Diagnostics and treatment strategy in patients with intracranial aneurysms suffered from autosomal dominant polycistosis kidney disease

The autosomal dominant polycistosis kidney disease (ADPK) is the severe hereditary disorder, which often combined with the formation of intracranial aneurysms (IA). Objective: to estimate the aneurysms frequency among the patients suffered from ADPK as well as the treatment strategy development for such patients. Material and methods: the prospective trial for revealing of IA among patients with ADPK using various neurovisualization methods is conducted. All patients with acute subarachnoid hemorrhage (SAH) suffered from ADPK who was admitted to our hospital were included in this study. The selection of treatment method was based on the evaluation of anatomical parameters of aneurysm and parent arteries. Results. We examined 47 patients with ADPK, IAs were revealed among 14 of them, 9 patients were operated on, among them 7 had history of SAH and 3 persons were operated on in acute period of SAH. Conclusion. The screening CT or MR-angiography is obligatory for patients with ADPK especially in the case of family history concerning SAH for revealing unruptured IAs for their future surgical treatment. The intraoperative monitoring in patient with chronic renal failure has to include the control of volemic status with uninterrupted registration of central venous pressure and usage of PiCCO method. It is preferred to conduct the surgical treatment of such patients under condition of multi-field hospital where the possibility for substitutive renal therapy is existed. The surgical treatment of patients suffered from IAs combined with ADPK does not lead to increase of lethality and bad treatment outcomes.

аневризма, субарахноидальное кровоизлияние, аутосомно-доминантный поликистоз почек, cerebral aneurysm, subarachnoid hemorrhage, autosomal dominant polycistosis kidney disease

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