Endovascular Treatment of a Ruptured Intracranial Arterial Aneurysm in a 12-Year-Old Child with Recessive Polycystic Kidney Disease

Abstract

A 12-year-old boy with recessive polycystic kidney disease and congenital hepatic failure, presented intracranial subarachnoid haemorrhage, due to the rupture of a laterobasilar tip aneurysm. In addition, he presented a left-sided middle cerebral unruptured aneurysm demonstrated during the screening procedure.

Our patient is a boy, like most children with intracranial aneurysms, but differs from children with intracranial aneurysms in polycystic kidney disease. The age of bleeding was low (actually the second youngest case reported), with a good Hunt and Hess grade at admission.

The localization of the aneurysm is exceptionally posterior (laterobasilar tip); in our case as intracranial aneurysms can be multifocal at that age. Renal function and blood pressure were normal. The endovascular GDC approach achieved a good result and excellent clinical outcome. Although most of what is known in this disease belongs to the autosomal dominant form, it is unclear whether the risk of a demonstrated unruptured intracranial aneurysm is the same as the risk of SAH from a non demonstrated one. It even seems that bleeding during follow-up in patients with polycystic kidney disease mostly occurs from non previously demonstrated intracranial aneurysms⁹.