HEADACHE If you have a history of aneurysms in your family, call your doctor and ask for an MRI of the brain to determine if you might have an aneurysm. Prior to surgery, this was a part of a surgical workup. With a family history of aneurysms, the surgeon is likely to include an aneurysm workup. A headache from an aneurysm is said to be the worse headache in the world
Migraine headaches sometimes occur when one has severe polycystic liver disease PLD and one is exposed to some type of liver toxins. There is also something called a caffeine migraine. Caffeine triggers a migraine 3 - 4 days after the event and it is usually a whooper of a headache. Those lucky enough to sense this headache coming on, can drink lemon juice mixed with hot water. Some have had the juice from 3-4 lemons in a single day.

Imitrex, a medication to relieve migraines, decreases kidney blood flow to the kidneys and should be avoided with PKD. Frequently travelers have noted that over sea airplanes are sprayed with strong pesticides. To diminish the headache from this, ask for cups of hot water with a lemon slice during the flight. Try this before the headache comes on to see if it will help it to abate. If lemon juice is not available try orange juice. Hot showers upon the neck area also help with headache pain.

ANEURYSM Occurs more frequently with PKD and with a history of a previous family member having had an aneurysm. Aneurysm rupture is a rare but devastating complication of PKD. It occurs in about 1 in 20 people with PKD without a family history but in up to nearly 1 in 5 people in whom there is a family history of rupture. For PKD'rs without any symptoms, the presence of a strong family history of rupture (at least 2 first degree relatives) remains the best predictor of rupture. Screening of this group might be feasible. Things associated with aneurysms:
heredity [thought to be found in the future on a particular gene]
smoking
nicotine use

second hand smoke
elevated blood pressure

All are thought to contribute to an aneurysm bursting. I heard of one small child 6 year old with PKD who had the worst headache of his life. This child had a ruptured aneurysm.

Incidence:
5% in the general population
10% with PKD
25% with PKD and family history

Other causes include trauma or injury to the head, high blood pressure, infection, tumors, atherosclerosis (a blood vessel disease in which fats build up on the inside of artery walls) and other diseases of the vascular system, cigarette smoking, and drug abuse. Some investigators have speculated that oral contraceptives may increase the risk of developing aneurysms.

What are the symptoms?

Most cerebral aneurysms do not show symptoms until they either become very large or burst. Small, unchanging aneurysms generally will not produce symptoms, whereas a larger aneurysm that is steadily growing may press on tissues and nerves. Symptoms may include pain above and behind the eye; numbness, weakness, or paralysis on one side of the face; dilated pupils; and vision changes. When an aneurysm hemorrhages, an individual may experience a sudden and extremely severe headache, double vision, nausea, vomiting, stiff neck, and/or loss of consciousness. Patients usually describe the headache as “the worst headache of my life” and it is generally different in severity and intensity from other headaches patients may experience. “Sentinel” or warning headaches may result from an aneurysm that leaks for days to weeks prior to rupture. Only a minority of patients have a sentinel headache prior to aneurysm rupture.

Other signs that a cerebral aneurysm has burst include nausea and vomiting associated with a severe headache, a drooping eyelid, sensitivity to light, and change in mental status or level of awareness. Some individuals may have seizures. Individuals may lose consciousness briefly or go into prolonged coma. People experiencing this “worst headache,” especially when it is combined with any other symptoms, should seek immediate medical attention. Once an aneurysm is discovered it can be clipped or a coil can be placed so it does not rupture. I had a screening done before my liver resection.