1/7. Is the rupture of cerebral berry aneurysms influenced by the perianeurysmal environment?PURPOSE: To evaluate contact between cerebral berry aneurysms and the perianeurysmal environment and to study the influence this contact has on aneurysm rupture. MATERIALS AND methods: In a series of 76 consecutive patients, pre- and post-contrast CT images of 87 aneurysms were evaluated. aneurysm locations were identified and aneurysms were divided into two different groups depending on whether they had ruptured or not. Contact between aneurysms and the perianeurysmal environment was studied when present, and considered to be balanced or unbalanced according to symmetry of contact and type of contact interface, i.e. with bone, dura, etc. RESULTS: rupture occurred in 47 aneurysms at an average maximum dome size of 7.4 mm. There was contact with elements of the perianeurysmal environment in 38 (81%) of ruptured cases and no evidence of contact in 7 (15%). The nature of contact was unclear in 2 (4%) ruptured aneurysms. In the aneurysms with contact, the nature of contact was unbalanced in 34 (72%) and balanced in 4 (9%). Unbalanced aneurysms ruptured at significantly smaller sizes (average: 7.7 mm) than balanced aneurysms (average: 11.4 mm). Seven aneurysms of small size (3.3-6.9 mm, average: 4.8 mm) were found to have ruptured, despite the fact that they were too small to exhibit contact with the perianeurysmal environment. In 40 unruptured aneurysms (average size: 6.3 mm), contact with the perianeurysmal environment was found in 15 aneurysms, for which balanced contact was found in 11 (27.5%) and unbalanced contact in 4 (10%), and no contact in 25 (62.5%). The average size of the aneurysms without contact (3.7 mm) was significantly smaller than that with balanced contact (10.3 mm) or with unbalanced contact (11.3 mm). CONCLUSION: Aneurysms exhibit contact with their perianeurysmal environment as soon as they reach a size that exceeds their allowance given by the local subarachnoid space. The contact with the environment was found to be an additional determinant parameter in the evolution of cerebral berry aneurysms and their risk to rupture.- - - - - - - - - - ranking = 1keywords = berry (Clic here for more details about this article) |
2/7. Carotid rupture during stent-assisted aneurysm treatment.We report the case of a supraclinoid carotid rupture during the delivery of a balloon-expandable stent in a 59-year-old patient with incidental paraclinoid berry aneurysms for whom stent-assisted coiling was planned. The deployment of the stent resulted in immediate rupture of the artery. We describe the emergent management of this complication with prolonged balloon inflation to occlude the site of rupture, a treatment that led to the discharge of the patient 2 weeks later without any sequelae.- - - - - - - - - - ranking = 0.16666666666667keywords = berry (Clic here for more details about this article) |
3/7. Berry splenic artery aneurysm rupture in association with segmental arterial mediolysis and portal hypertension.A rare case of berry splenic artery aneurysm (SAA) rupture associated with segmental arterial mediolysis (SAM) and portal hypertension is reported. A 66-year-old woman, diagnosed as having liver cirrhosis and portal hypertension 6 years earlier, suddenly developed a lancinating pain in the upper abdomen and lost consciousness. She recovered consciousness while being transferred to hospital by ambulance. During the investigations, her level of consciousness suddenly deteriorated. ultrasonography showed a massive intraperitoneal hemorrhage, and she died 5(1/2) h after admission. On gross examination at autopsy it was not possible to find the rupture point of the vessel because the pancreas was embedded in a massive hematoma. However, careful dissection of the pancreatic tail after fixation revealed a berry aneurysm measuring 0.8 cm in diameter in a branch adjacent to the bifurcation in the distal third of the main splenic artery. Microscopic examination detected a rupture of the aneurysm. The histology of the arterial wall proximal to the aneurysm showed typical SAM. In general, berry SAA caused by SAM is rare and unlikely to rupture. The SAA in the present case likely occurred and ruptured due to the combination of SAM and portal hypertension.- - - - - - - - - - ranking = 0.5keywords = berry (Clic here for more details about this article) |
4/7. Traumatic pericallosal artery aneurysm.We present the case of a 33-year-old man who sustained head trauma in a motor vehicle accident. He remained unconscious from the time of the accident until his death 10 days later. He was shown to have severe hemorrhage that destroyed the corpus callosum from genu to splenium in association with a pericallosal artery aneurysm (distal anterior cerebral artery aneurysm). In addition, hemorrhages typical of traumatic hemorrhages were found elsewhere in the brain. Clinically, he was considered to have suffered the rupture of a berry pericallosal artery aneurysm, which caused the motor vehicle accident. review of the angiograms in relation to the forensic neuropathologic examination revealed features indicating that the aneurysm had a traumatic origin. We also discuss traumatic pericallosal artery aneurysms in the wider context of traumatic cerebral artery aneurysms. Features that aid in distinguishing traumatic from spontaneous berry aneurysm are considered. Only 17 cases of traumatic cerebral artery aneurysms have been reported in this site. To the best of our knowledge, this is the first such case to be reported in the forensic setting.- - - - - - - - - - ranking = 0.33333333333333keywords = berry (Clic here for more details about this article) |
5/7. Acute aortic dissections and ruptured berry aneurysms associated with methamphetamine abuse.Sudden, unexpected death can occur following rupture of an artery weakened by aneurysmal dilatation or by medial dissection. In both of these diseases the arterial abnormality is exacerbated by hypertension. This arterial weakness could also be aggravated by the use of drugs with a hypertensive effect. We report seven cases of sudden death in patients abusing methamphetamine--four cases of ruptured berry aneurysms and three cases of aortic dissection with cardiac tamponade. The autopsy findings are reviewed, and various mechanisms are considered by which methamphetamine may contribute to death in such cases.- - - - - - - - - - ranking = 0.83333333333333keywords = berry (Clic here for more details about this article) |
6/7. Fatal traumatic vertebral artery aneurysm rupture. Case report.The authors present the case of a 34-year-old man struck over the left mastoid region by a hockey puck, who suffered a fatal rupture of a left vertebral artery berry aneurysm. He became apneic within seconds of the injury and had no brainstem reflex within minutes. The postmortem examination showed massive subarachnoid hemorrhage in the posterior fossa and the remnants of a berry aneurysm near the intradural origin of the left vertebral artery, 11 mm proximal to the posterior inferior cerebellar artery. rupture of a saccular aneurysm as a result of head trauma is rare. This is the first reported case of a posterior circulation aneurysm rupture as a result of head trauma.- - - - - - - - - - ranking = 0.33333333333333keywords = berry (Clic here for more details about this article) |
7/7. death due to a ruptured berry aneurysm in a 3.5-year-old child.Berry aneurysms in childhood are rare and have certain characteristics that distinguish them from their adult counterparts. A case of death caused by a ruptured berry aneurysm in a child is presented, and the topic is reviewed.- - - - - - - - - - ranking = 0.83333333333333keywords = berry (Clic here for more details about this article) |