Ruptured berry aneurysm

Rupture of a berry aneurysm, also known as a saccular aneurysm, can cause either a subarachnoid haemorrhage (SAH), cerebral haematoma and/or intraventricular haemorrhage.

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).

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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: ~5%, prepontine cistern
  • ICA: Sylvian fissure and intra-ventricular
  • pericallosal artery: corpus callosum
  • PICA: foramen magnum
  • length-to-neck ratio > 1.6
  • increased volume to surface area
  • aneurysm angulation
  • presence of an apical bleb

The rupture of an intracranial aneurysm is a medical emergency with a high mortality index 3.  

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Article information

rID: 14401
Section: Gamuts
Synonyms or Alternate Spellings:
  • Berry aneurysm rupture
  • Saccular aneurysm rupture

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Cases and figures

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    3D TOF MRA
    Case 1: ruptured basilar tip aneurysm
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    Case 2: MCA aneurysm
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    Case 3: SAH due a left MCA aneurysm
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