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Pathology

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Central Nervous System

Question
14 out of 24
 

The best described etiology for Berry aneurysm is which of the following? (AIIMS May 2013)



A Degeneration of internal elastic lamina

B Degeneration of tunica media

C Defect in muscular layer

D Low grade inflammation in the vessel wall

Ans. B Degeneration of tunica media (Ref Robbins 8th11297-8)

Direct quote from Robbins 'the berry aneurysms develop over time because of an undertlying defect in the media of the vessel.

Concept

It is different from other causes of aneurysm (atherosclerosis, subarachnoid hemorrhage.

Salient points about Berry aneurysm (saccular aneurysm)

Saccular aneurysm is the most common type of intracranial aneurysm.

Risk factors

Smoking and hypertension are the important risk factors for Berry aneurysm. They are not the result of atherosclerosis (which sa disease of intima).

Berry aneurysms are called congenital, although the aneurysm itself is present at birth

Location

Commonest location is in the circle of Willis, typically at the junction of the anterior communicating artery with the anterior cerebral

arteryo.

It is also present at the middle cerebral artery and the posterior communicating artery.

Clinical

It is responsible for a clinically significant subarachnoid hemorrhage. ln fact, excluding trauma, berry aneurysm is the commonest cause of subarachnoid hemorrhage.

The chance of rupture of berry aneurysms increases with age (rupture is rare in childhood). Rupture causes marked bleeding into the

subarachnoid space and produces severe headaches,typically described as the worst headache ever.

Central Nervous System Flashcard List

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