Pathology - Subarachnoid Hemorrhage and Berry Aneurysm
Subarachnoid bleeding can be caused by the rupture of a berry aneurysm, trauma, or arteriovenous malformation. Berry aneurysms typically happen randomly, however variables that increase the risk include hypertension, smoking, aortic coarctation, APKD, connective tissue disorders, and neurofibromatosis type I. Berry aneurysms are more likely to rupture in women and individuals over the age of 40. Subarachnoid hemorrhage is the presence of blood in the subarachnoid space. Fibrosis, which might occur after the blood is cleared, may cause obstruction of cerebrospinal fluid. Berry aneurysm typically develops at the junctions of arteries in the circle of Willis. It involves a bulging of the artery wall due to thickening of the inner layer and thinning of the middle layer at the neck of the aneurysm, with the middle layer being absent in the sac wall. Clinical presentation of subarachnoid hemorrhage includes severe headache, nausea, vomiting, loss of consciousness, possible fever, and nuchal stiffness. It can be life-threatening. Laboratory results: Blood is found in the cerebrospinal fluid after a lumbar puncture. Imaging: CT scan shows blood in basal cisterns. Therapy Treatment options include surgical repair, coil embolization, and supportive care, with the therapeutic method determined by cerebral angiography. Arteriovenous malformations are vascular anomalies present from birth in the cerebrum, typically seen in the subarachnoid space but can also extend into brain tissue. The symptoms typically appear in young people as seizures or cerebral bleeding.
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