BERRY ANEURYSM

• Berry aneurysm are thin walled arterial outpouchings in cerebral vessels.
• They are saccular in appearance.
• Developmental defect of the media of the arterial wall at the bifurcation of arteries forming thin-walled saccular bulges.
• Haemorrhage into subarchanoid space [subarchanoid hemorrhage (SAH)] is most commonly caused by rupture of an aneurysm.
• Large intracranial arteries-

1. Berry (MC)
2. Mycotic
3. Fusiform

• The four most common sites of such aneurysms are-

1. anterior communicating artery.
2. At the origin of the posterior communicating artery from the stem of the internal carotid artery.
3. At the first major bifurcation of the middle cerebral artery.
4. At the bifurcation of the internal carotid into the middle and anterior cerebral arteries

CLINICAL FEATURES-

• MC manifestation of berry aneurysm is rupture into subarchanoid space (subarchanoid hemorrhage).
• Berry aneurysm most commonly located on Circle of Willis (anterior cerebral artery)
• Chest and abdominal pain
• Sentinel headache.
• Seen in females more from 50- 60 years.
• Rise in intracranial pressure and characteristic blood stained CSF.
• Developmental anomaly

INVESTIGATIONS-

• CT scan- detects acute SAH
• MRI more sensitive in detecting chronic SAH.
• CT angiography- detects berry aneurysm.

TREATMENT-

• EVAR

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