How often do you screen for cerebral aneurysms in patients with autosomal dominant polycystic kidney disease who do not have a family history of intracranial aneurysms or for whom the family history is unknown?

We recently wrote an editorial about this topic. Our conclusion was as follows: "considering the potential for morbidity and mortality in this unique population at risk for ICAs with possibly higher-than-average risk of rupture, we believe that presymptomatic screening for ICA in all individuals with ADPKD regardless of family history is warranted. Frequency of follow-up screening in cases of incidental small ICA or to detect de novo ICAs is likely justifiable at a 5-year interval based on cost-effectiveness analyses." However, the topic is controversial and reading the debate (PRO and CON) may be worthwhile to grasp the nuances and considerations for counseling your patients.

Eswarappa & Park, PMID 37990366