Intracranial aneurism - Intracranial aneurysm formation

About 8% of ADPKD patients have an asymptomatic intracranial aneurysm and the prevalence is twice as high in the subgroup of patients with a family history of such aneurysms or of subarachnoid haemorrhage.

Such haemorrhage is preceded in from 20-40% of cases by premonitory headaches from a few hours up to 2 weeks before the onset of subarachnoid bleeding.

Headache of sudden onset or unusual character or severity in a patient with ADPKD should prompt investigation. Contrast-enhanced spiral CT is the best investigation.

Screening for intracranial aneurysm in ADPKD is currently recommended for patients aged 18-40 years who have a positive family history. Screening is performed either by magnetic resonance angiography or spiral CT.

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