In ADPKD, which extrarenal anomaly is associated with an increased risk of subarachnoid hemorrhage?

• A. Berry aneurysms in the circle of Willis
• B. Hepatic cysts
• C. Hypertension
• D. Retinopathy

Answer: (A)

ADPKD often extends beyond the kidneys to blood vessels, especially intracranial arteries. These vessels can develop saccular (berry) aneurysms in the circle of Willis, and rupture of one of these aneurysms releases blood into the subarachnoid space, causing a subarachnoid hemorrhage. That connection makes berry aneurysms the best answer for the question about an extrarenal anomaly linked to higher SAH risk in ADPKD. The other options—hepatic cysts, hypertension, and retinopathy—are common in ADPKD but do not specifically explain the increased risk of subarachnoid hemorrhage.