Comparison of intracerebral hemorrhage and subarachnoid hemorrhage in patients with autosomal-dominant polycystic kidney disease

Nephron Clin Pract. 2010;114(2):c158-64. doi: 10.1159/000256568. Epub 2009 Nov 7.

Abstract

Background/aims: Subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH) are two subtypes of hemorrhagic stroke that may cause severe complications in patients with autosomal-dominant polycystic kidney disease (ADPKD). The differences in clinical features between SAH and ICH associated with ADPKD are not known.

Methods: Among 647 ADPKD patients hospitalized between 1997 and 2007 in our hospital, 11 with ICH (1.7%) and 6 with SAH (0.9%) were identified.

Results: Patients with SAH were significantly younger than patients with ICH (39 +/- 6 vs. 57 +/- 15 years, p = 0.013). The systolic blood pressure on admission was significantly higher in patients with ICH (194 +/- 26 vs. 145 +/- 18 mm Hg, p = 0.001). Two patients (18.2%) with ICH died after a first episode, 6 had a second episode, and 2 had a third episode. Two patients (33.3%) with SAH died after a first episode but the survivors had no recurrence during follow-up. The 30-day survival curves comparing patients with ICH and SAH were not significantly different. Patients with a Glasgow Coma Score less than 9 on arrival had a significantly worse outcome.

Conclusion: Clinical features differed between ICH and SAH associated with ADPKD. Nevertheless, blood pressure control and early recognition of hemorrhagic stroke are important in ADPKD patients.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cerebral Hemorrhage / diagnosis*
  • Cerebral Hemorrhage / mortality*
  • Comorbidity
  • Female
  • Humans
  • Male
  • Middle Aged
  • Polycystic Kidney, Autosomal Dominant / diagnosis*
  • Polycystic Kidney, Autosomal Dominant / mortality*
  • Prevalence
  • Risk Assessment
  • Risk Factors
  • Subarachnoid Hemorrhage / diagnosis*
  • Subarachnoid Hemorrhage / mortality*
  • Survival Analysis
  • Survival Rate
  • Taiwan / epidemiology