Berry Aneurysm
What is a Berry Aneurysm?
It is a name given to a type of aneurysm which occurs at the brain’s base portion. It has another name which is termed as saccular aneurysm. It is a lobulated or round focal protrusion that rises from bifurcation of the arterial area which rises direct from the non branching arterial wall.
It is commonly developed at the portion where there is a congenitally absent or thin tunica media and there is a fragmented or absent internal elastic of the walls of the artery. It is known to expand and develop as time elapses.
They occur more often in persons who are hypertensive wherein when there is an increase in pressure, the vessel of the arterial wall bulges which might lead to rupture and hemorrhage of the subarachnoid area. Amongst the different kind or types of aneurysm, the berry aneurysm is the most common of all types. It is derived from the Greek word called aneurysm or otherwise termed as widening.
Belly Aneurysm Image
Berry Aneurysm Causes
There is still an unknown factor as to why berry aneurysm is diagnosed to some persons. However, there are theories of the etiological factors that may be the cause of why such condition occurs. Some of them are as follows:
- Defect in the hereditary genetic
- Due to diseases such as:
- Atherosclerosis
- Hypertension
- Diabetes
- Abnormal flow of blood at the junction of the arteries which leads to damage of the arterial wall
- Tumors of the neck and head
- Trauma or injury of the head
- Obesity
- Elderly persons
- Regular consumption of beverages that are alcoholic in nature
- Smoking
Berry Aneurysm Pathophysiology
Before the person develops berry aneurysm, it all boils down to the arterial wall which is anatomically made up many different layers which plays a very important role in the flexibility and strength of the vessels. The intracranial aneurysms are classified in three kinds, one of which is berry or saccular aneurysm which occurs around 90 percent than other kinds of aneurysm.
It actually develops from the defect of the arterial muscular layer or otherwise termed as Tunica Muscularis. The person with berry aneurysm, have alteration of their internal elastic membrane or medically termed as lamina elastica interna of the arterial found in the cerebral area which are thought to let the vessel wall weaken and rendering it to a lesser change resistant in the pressure of the intraluminal areas.
The changes, mentioned, are commonly developed at the bifurcation of the arterial vessel, where the flow of blood is known to have a shear force and is most turbulent. Such factors will lead to the aggravation of the high tendency for this certain portion to balloon out and results to an aneurysm, particularly berry aneurysm which is the most common of them all.
Berry Aneurysm Symptoms
Most persons who have berry aneurysm live asymptomatically and will remain such until it ruptures, where the symptoms would be present. Yet most of them who have unruptured kind of aneurysm do show signs and symptoms which are as follows:
- Transient form of ischemia
- Seizure
- Severe or worsening headache
- Vision loss
- Oculomotor nerve palsy
- Nausea
- Numbness
- Stiff neck
- Double vision or diplopia
- Unilateral optic neuropathy
- Pain in the persons face
- Weakness of the motor area
- Cranial neuropathy which does not involve the persons eye
Berry Aneurysm Diagnosis
In detecting berry aneurysm, there are medical examination procedures to be done such as:
Computed Tomography Angiography or CTA scan
It is a much less expensive and quicker way to detect aneurysm. CT scan is not very good in detecting berry aneurysm.
MRI or Magnetic Resonance Imaging
It uses radio waves as well as magnetic field which create either 2D or 3D images of the brain in slices.
MRA or Magnetic Resonance Angiography
It is the acceptable and safe way of detecting berry aneurysm. Here, the physician can either use a dye to enhance further the blood vessel images and to be able to accurately detect the aneurysm area which is ruptured.
Cerebrospinal Fluid Test
It is done especially if the person has a ruptured aneurysm. It is used to check if there is a presence of red blood cells in the spinal fluid which surrounds the spine and the brain itself.
CTA scan to determine presence of berry aneurysm
Berry Aneurysm Treatment
Persons who have berry aneurysm are told to consult their doctors prior to the rupture of the aneurysm. The treatment will greatly depend on the aneurysm’s location, size and the person’s age. Most often, the persons who have berry aneurysms are asymptomatic and will only manifest symptoms when the aneurysm ruptures and have subarachnoid kind of hemorrhage. The ruptured berry aneursym is treated with a surgical procedure. There are actually two kinds of surgical procedures done such as:
Endovascular coiling
Amongst the two, this is a lesser invasive surgical procedure wherein the surgeon will insert a catheter into the person’s artery via the groin and will thread it to the location of the aneurysm. The wire will basically coil up inside the area od the aneurysm and will disrupt the flow of blood which will lead to clotting. Clootting is necessary to seal of the arterial aneurysm.
Clipping surgically
It is a surgical procedure that closes off the aneurysm. The surgeon will remove the skill to be able to access the area of the aneurysm and will search for the blood vessels that is near the aneurysm and clips the aneurysm’s neck to prevent the flow of blood and to prevent rupture.
Other treatments which will be aimed in managing the complication and relieving the other symptoms, include:
- Pharmacological Medications such as:
- Calcium channel blockers
- Analgesics
- Drugs for anti seizure
- Shunt surgical procedure
- Oxygen therapy
- Intravenous fluids
- Rehabilitation therapy such as:
- Physical therapy
- Occupational therapy
- Speech therapy
Berry Aneurysm Complications
There is a higher tendency that the aneurysm may rupture and bleed which may lead to some serious complications which includes:
- Permanent nerve damage
- Hemorrhagic stroke
- Hydrocephalus
- Vasospasm
- Death