Pedigree — Polycystic Kidney Disease ADPKD

A 35-year-old man with a family history of autosomal dominant polycystic kidney disease (ADPKD) is referred for genetic counseling. On examination, he has hypertension and bilateral flank masses. Imaging confirms bilateral renal cysts consistent with ADPKD. The pedigree shows vertical transmission across three generations with 50% of offspring affected. Beyond the renal pathology, the labeled structures **D** in the diagram represent extra-renal manifestations commonly associated with ADPKD. Which of the following best describes the screening recommendation for the most clinically significant extra-renal manifestation in this patient?