Ruptured Cerebral Aneurysm and Acute Bilateral Carotid Artery Dissection in a Patient with Polycystic Kidney Disease and Polycystic Liver Disease

Roth, Christian; Kleffmann, Jens; Bergmann, Carsten; Deinsberger, Wolfgang; Ferbert, A.

doi:10.1159/000350727

Cited by 13 publications

(6 citation statements)

References 14 publications

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“…Vascular manifestations of the disease are due to the fact that both polycystins are expressed within arterial smooth muscle cells [2][3][4], and a systemic vascular defect was observed already on oligosymptomatic stage of the disease [5,6]. In effect, ADPKD patients are at risk for arterial complications [7].…”

Section: Introductionmentioning

confidence: 99%

Blood Pressure and Intracranial Aneurysms in Autosomal Dominant Polycystic Kidney Disease

Niemczyk¹,

Pilecki²,

Gradzik

et al. 2014

Kidney Blood Press Res

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Background/Aims: Autosomal dominant polycystic kidney disease (ADPKD) is correlated with an increased frequency of both intracranial aneurysms (ICANs), and arterial hypertension (AH). The aim of our study was to search for the association between blood pressure (BP) and ICANs in ADPKD patients. Methods: Sixty-eight adult, pre-dialysis phase ADPKD patients underwent both screening for ICANs with magnetic resonance angiography of the brain, and ambulatory blood pressure monitoring (ABPM). Results: ICANs were diagnosed in 10 patients (ICAN(+) group), while in 58 were not (ICAN(-) group). The nighttime maximum diastolic blood pressure (DBP), maximum increase in DBP from measurement to measurement (positive delta of DBP) at night, and the standard deviation of the daytime mean arterial pressure were significantly higher in ICAN(+) compared to ICAN(-) patients. Additionally, in a subgroup of patients after 45 years-of-age, ICAN(+) patients had significantly higher maximum 24-hour and daytime systolic blood pressure, maximum 24-hour, daytime, nighttime DBP, maximum daytime and nighttime positive delta of DBP compared to ICAN(-) cases. Conclusions: Development of ICANs in hypertensive ADPKD patients is accompanied with higher values of some BP parameters measured by ABPM. Hypertensive ADPKD patients with substantial fluctuations in BP assessed by ABPM, especially those after 45 years-of-age, should become candidates for screening for ICANs.

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Section: Introductionmentioning

confidence: 99%

Blood Pressure and Intracranial Aneurysms in Autosomal Dominant Polycystic Kidney Disease

Niemczyk¹,

Pilecki²,

Gradzik

et al. 2014

Kidney Blood Press Res

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“…Spontaneous extracranial ICA dissection associated with ADPKD is extremely rare, with only nine cases reported in the English literature to date, including our patient ( Table 1 ) [ 5 , 6 , 7 , 8 , 9 ]. We analyzed these cases, which included four women and five men with a mean age of 41.1 years.…”

Section: Discussionmentioning

confidence: 99%

A Spontaneous Extracranial Internal Carotid Artery Dissection with Autosomal Dominant Polycystic Kidney Disease: A Case Report and Literature Review

et al. 2022

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Background and Objectives: Non-cystic manifestation of autosomal dominant polycystic kidney disease (ADPKD) is an important risk factor for cerebral aneurysms. In this report, we describe a rare spontaneous internal carotid artery (ICA) dissection in a patient with ADPKD. Observations: A 38-year-old woman with a history of ADPKD and acute myocardial infarction due to coronary artery dissection experienced severe spontaneous pain on the left side of her neck. Magnetic resonance imaging (MRI) revealed a severe left ICA stenosis localized at its origin. Carotid plaque MRI showed that the stenotic lesion was due to a subacute intramural hematoma. Close follow-up by an imaging study was performed under the diagnosis of spontaneous extracranial ICA dissection, and spontaneous regression of the intramural hematoma was observed uneventfully. Conclusions: When patients with a history of ADPKD present with severe neck pain, it is crucial to consider the possibility of a spontaneous ICA dissection. A carotid plaque MRI is beneficial in the differential diagnosis. Conservative management may benefit patients without ischemic symptoms.

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“…In addition, heritable connective tissue disorders such as Ehlers–Danlos syndrome, Marfan’s syndrome, are associated with an increased risk of spontaneous ICAD [3]. ADPKD has also been rarely described as correlating with dissection of the cerebral arteries [14–16]. ADPKD is the most common inherited renal cystic disease and it is associated with various extrarenal manifestations, such as polycystic liver disease [17], cardiac valvular anomalies, and colonic diverticular and vascular complications.…”

Section: Discussionmentioning

confidence: 99%

Isolated hypoglossal nerve palsy from internal carotid artery dissection related to PKD-1 gene mutation

Chen

Yuan

et al. 2019

BMC Neurol

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BackgroundInternal carotid artery dissection has been well recognized as a major cause of ischaemic stroke in young and middle-aged adults. However, internal carotid artery dissection induced hypoglossal nerve palsy has been seldom reported and may be difficult to diagnose in time for treatment; even angiography sometimes misses potential dissection, especially when obvious lumen geometry changing is absent.Case presentationWe report a 42-year-old man who presented with isolated hypoglossal nerve palsy. High-resolution MRI showed the aetiological dissected internal carotid artery. In addition, a potential genetic structural defect of the arterial wall was suggested due to an exon region mutation in the polycystic-kidney-disease type 1 gene.ConclusionsHypoglossal nerve palsy is a rare manifestations of carotid dissection. High-resolution MRI may provide useful information about the vascular wall to assist in the diagnosis of dissection. High-throughput sequencing might be useful to identify potential cerebrovascular-related gene mutation, especially in young individuals with an undetermined aetiology.

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Ruptured Cerebral Aneurysm and Acute Bilateral Carotid Artery Dissection in a Patient with Polycystic Kidney Disease and Polycystic Liver Disease

Cited by 13 publications

References 14 publications

Blood Pressure and Intracranial Aneurysms in Autosomal Dominant Polycystic Kidney Disease

Blood Pressure and Intracranial Aneurysms in Autosomal Dominant Polycystic Kidney Disease

A Spontaneous Extracranial Internal Carotid Artery Dissection with Autosomal Dominant Polycystic Kidney Disease: A Case Report and Literature Review

Isolated hypoglossal nerve palsy from internal carotid artery dissection related to PKD-1 gene mutation

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