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


CONCLUSIONS
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.
Chang
Ming-Yang
MY
Department of Nephrology and Kidney Research Center, Chang Gung Memorial Hospital, and School of Medicine, Chang Gung University, Linkou, Taiwan. mingyc @ adm.cgmh.org.tw
Kuok
Chi-Man
CM
Chen
Yung-Cheng
YC
Ryu
Shan-Jin
SJ
Tian
Ya-Chung
YC
Wu-Chou
Yah-Huei
YH
Tseng
Fang-Ji
FJ
Yang
Chih-Wei
CW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000401:mortality*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016891:Polycystic Kidney, Autosomal Dominant / Q000175:diagnosis* / Q000401:mortality*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000401:mortality*; D016019:Survival Analysis; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology