Acute Spontaneous Subdural Hematoma in a Patient With Autosomal Dominant Polycystic Kidney Disease

ADPKD

Abstract

Central nervous system (CNS) manifestations in autosomal dominant polycystic kidney disease (ADPKD) typically include intracranial aneurysms, arachnoid cysts, and dolichoectasia, which can lead to subarachnoid or chronic subdural hemorrhages. A review of the literature identified limited case of acute SDH in a patient with ADPKD, along with several reports of chronic SDH in this population. This suggests that acute SDH may be underrecognized in ADPKD, potentially progressing to the chronic stage and resulting in higher morbidity and mortality. In this report, we describe a case of acute SDH in a 42-year-old woman with ADPKD who presented with a severe right-sided headache, facial pain, and focal seizures in the absence of conventional risk factors or identifiable intracranial pathology. She was managed conservatively, and her neurological symptoms gradually improved. Comprehensive cerebral imaging, including magnetic resonance angiography and magnetic resonance venography, revealed no evidence of aneurysms, arachnoid cysts, venous sinus thrombosis, or other vascular abnormalities commonly associated with ADPKD. Although acute SDH is rare in ADPKD, and may be easily overlooked, allowing progression to chronic SDH. Therefore, maintaining a high index of clinical suspicion in patients with ADPKD is essential for early diagnosis and prevention of SDH-related complications