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Surgery General 123c16bf

True about berry-aneurysm is following except ?

A
Associated with familial syndrome
B
Most common site of rupture is apex which causes SAH
C
Wall contains smooth muscle fibroblasts
D
90% occurs at ant. pa of circulation at branching point
High-Yield Explanation
Answer is 'c' i.e. Wall contains smooth muscle fibroblasts The wall of Berry aneurysm is made up of thickened hyalinized intima. The adventitia covering the sac is continuous with that of the parent aery. Berry aneurysm (or Saccular or congenital aneurysm) Are the most common type of intracranial aneurysm (other rarer type of aneurysms include atherosclerotic, mycotic, traumatic and dissecting aneurysms). About 90% of berry aneurysms occur in the anterior circulation and are found near the major aerial bifurcations. * Multiple aneurysms exist in 20% - 30% of cases, many at mirror sites bilaterally Etiology & Pathogenesis The etiology is unknown, the underlying congenital weakness of the wall is considered to be the cause. There is increased risk of berry aneurysms in following conditions : a) Autosomal Polycistic Kidney Ds. d) Marfans syndrome b) Ehlers-Danlos syndrome e) Fibromuscular dysplasia c) Neurofibromatosis type I f) Coarctation of aoa Predisposing factors a) Cigarette smoking b) Hypeension Rupture of aneurysm usually occurs at the apex (i.e. dome) of the sac, resulting in subarchnoid haemorrhage or intraparenchymal haemorrhage or both. Unruptured aneurysms are usually completely asymptomatic.

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