Ruptured saccular aneurysm
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Rupture of a berry aneurysm, also known as a saccular aneurysm, can cause either a subarachnoid haemorrhage (SAH), cerebral haematoma and/or intraventricular haemorrhage.
Epidemiology
Berry aneurysms form 97% of aneurysms of the central nervous system. Up to 80% of patients with a spontaneous subarachnoid haemorrhage have ruptured an aneurysm. 90% of these aneurysms are located in the anterior circulation (carotid system) and 10% are found in the posterior circulation (vertebrobasilar system).
Clinical presentation
- content pending
Pathology
- content pending
Radiographic features
Determining the site of rupture
After rupture, the location of the blood or haematoma can help determine the site of the ruptured aneurysm in the majority of cases:
- ACOM: ~35%, septum pellucidum, interhemispheric fissure and intraventricular
- PCOM: ~35%, Sylvian fissure
- MCA: ~20%, temporal lobe, Sylvian fissure and intraventricular
- basilar artery: ~5%, prepontine cistern
- ICA: Sylvian fissure and intra-ventricular
- pericallosal artery: corpus callosum
- PICA: foramen magnum
Aneurysmal characteristics suggestive of rupture 4
- length-to-neck ratio > 1.6
- increased volume to surface area
- aneurysm angulation
- presence of an apical bleb
Treatment and prognosis
The rupture of an intracranial aneurysm is a medical emergency with a high mortality index 3.
See also
-<p><strong>Rupture of a berry aneurysm</strong>, also known as a <a href="/articles/saccular-cerebral-aneurysm">saccular aneurysm</a>, can cause either a <a href="/articles/subarachnoid-haemorrhage">subarachnoid haemorrhage (SAH)</a>, cerebral haematoma and/or <a href="/articles/intraventricular-haemorrhage">intraventricular haemorrhage</a>.</p><h4>Epidemiology</h4><p><a href="/articles/saccular-cerebral-aneurysm">Berry aneurysms</a> form 97% of aneurysms of the central nervous system. Up to 80% of patients with a spontaneous subarachnoid haemorrhage have ruptured an aneurysm. 90% of these aneurysms are located in the anterior circulation (carotid system) and 10% are found in the posterior circulation (vertebrobasilar system).</p><h4>Clinical presentation</h4><ul><li><em>content pending </em></li></ul><h4>Pathology</h4><ul><li><em>content pending </em></li></ul><h4>Radiographic features</h4><h5>Determining the site of rupture</h5><p>After rupture, the location of the blood or haematoma can help determine the site of the ruptured aneurysm in the majority of cases:</p><ul>- +<p><strong>Rupture of a berry aneurysm</strong>, also known as a <a href="/articles/saccular-cerebral-aneurysm">saccular aneurysm</a>, can cause either a <a href="/articles/subarachnoid-haemorrhage">subarachnoid haemorrhage (SAH)</a>, <a title="Intraparenchymal cerebral bleed" href="/articles/intracerebral-haemorrhage">cerebral haematoma</a> and/or <a href="/articles/intraventricular-haemorrhage">intraventricular haemorrhage</a>.</p><h4>Epidemiology</h4><p><a href="/articles/saccular-cerebral-aneurysm">Berry aneurysms</a> form 97% of aneurysms of the central nervous system. Up to 80% of patients with a spontaneous subarachnoid haemorrhage have ruptured an aneurysm. 90% of these aneurysms are located in the anterior circulation (carotid system) and 10% are found in the posterior circulation (vertebrobasilar system).</p><h4>Clinical presentation</h4><ul><li><em>content pending </em></li></ul><h4>Pathology</h4><ul><li><em>content pending </em></li></ul><h4>Radiographic features</h4><h5>Determining the site of rupture</h5><p>After rupture, the location of the blood or haematoma can help determine the site of the ruptured aneurysm in the majority of cases:</p><ul>
-<strong>ACOM:</strong> ~35%, septum pellucidum, interhemispheric fissure and intraventricular</li>- +<strong>ACOM:</strong> ~35%, <a title="Septum pellucidum" href="/articles/septum-pellucidum">septum pellucidum</a>, <a href="/articles/interhemispheric-fissure">interhemispheric fissure</a> and intraventricular</li>
-<strong>PCOM:</strong> ~35%, Sylvian fissure</li>- +<strong>PCOM:</strong> ~35%, <a title="Sylvian fissure" href="/articles/sylvian-fissure">Sylvian fissure</a>
- +</li>
-<strong>MCA:</strong> ~20%, temporal lobe, Sylvian fissure and intraventricular</li>- +<strong>MCA:</strong> ~20%, <a title="Temporal lobe" href="/articles/temporal-lobe">temporal lobe</a>, Sylvian fissure and intraventricular</li>
-<strong>basilar:</strong> ~5%, prepontine cistern</li>- +<strong>basilar artery:</strong> ~5%, <a title="Prepontine cistern" href="/articles/pontine-cistern">prepontine cistern</a>
- +</li>
-<strong>pericallosal artery:</strong> corpus callosum</li>- +<strong>pericallosal artery:</strong> <a title="Corpus callosum" href="/articles/corpus-callosum">corpus callosum</a>
- +</li>
-<strong>PICA:</strong> foramen magnum</li>- +<strong>PICA:</strong> <a title="Foramen magnum" href="/articles/foramen-magnum">foramen magnum</a>
- +</li>
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