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

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.