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).
- content pending
- content pending
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: ~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.
- 1. Dähnert W. Radiology Review Manual. Lippincott Williams & Wilkins. (2011) ISBN:1609139437. Read it at Google Books - Find it at Amazon
- 2. Adam A, Dixon AK, Grainger RG et-al. Grainger and Allison's diagnostic radiology, a textbook of medical imaging. Churchill Livingstone. (2007) ISBN:0443101639. Read it at Google Books - Find it at Amazon
- 3. Bederson JB, Awad IA, Wiebers DO et-al. Recommendations for the management of patients with unruptured intracranial aneurysms: A Statement for healthcare professionals from the Stroke Council of the American Heart Association. Stroke. 2000;31 (11): 2742-50. doi:10.1161/01.STR.31.11.2742 - Pubmed citation
- 4. Alexander MD, Ko NU, Hetts SW. Imaging of intracranial hemorrhage: Subarachnoid hemorrhage and its sequelea. Apllied Radiology Nov 2015.