Thursday, November 18, 2010

Berry aneurysm

A berry aneurysm refers to an intracranial aneurysm with a characteristic shape which accounts for the vast majority of intracranial aneurysms as well as non-traumatic subarachnoid haemorrhages. They occur at branch points, usually of sizable vessels, but sometimes at the origin of small perforators which may not be seen on imaging.

This photo on the right is Photo of a Norwegian blueberry.

Pathology

The aneurysmal pouch is composed of thickened hyalinised        intima with the muscular wall & internal elastic lamina being absent.

Comments required on a radiology report:

* size : ideally 3 axis maximum size meansurements
* neck : maximal width of the neck of the aneurysm
* shape and lobulations
* orientation : the direction in which the aneurysm points is often important in both endovascular and surgical planning
This small berry aneurysm projecting inferiorly from the ACOM had pushed into the optic chiasm causing a bitemporal hemianopia, similar to that seen in pituitary lesions.

SAH angiogram

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