Arterial Aneurysms, Dissections and Malformations MCQs

Spontaneous subarachnoid haemorrhage (SAH) is usually the result of - Bleeding from a ruptured aneurysm (~80% of SAH) Arteriovenous malformation (AVM) Most ruptured aneurysms are located in the circle of Willis , at branch points in the arterial tree associated with turbulent blood flow. Reference : Bailey & Love's short practice of surgery 28th Edition, Chapter 48, Cranial neurosurgery, Pg: 708-709.

Explanation: Autosomal dominant polycystic kidney disease (ADPKD) results from mutations in Polycystin-1 (chromosome 16) and polycystin-2 (chromosome 4) (Option A). Features: Renal size increases with age, leading to flank or abdominal masses in some patients. Cysts contain clear fluid, thick brown material or coagulated blood. Visible haematuria occurs in up to 40% of patients with ADPKD (Option C) . Cyst haemorrhage is a frequent complication with or without haematuria, depending on whether the cyst communicates with the collecting system or not. Hypertension is the most common manifestation of ADPKD and a major contributor to renal disease progression and cardiovascular morbidity and mortality. After the age of 20 years, most patients are hypertensive. Associated with intracranial aneurysms in 10% of cases (Option B) .