questions 3

Aneurysms

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Topic updated on 01/10/17 9:59am

Large Vessel Aneurysm
 


  • Introduction
    • aka berry aneurysm
      • MC are communicating circulation of the circle of Willis 
        • most common is at the bifurcation of anterior communicating artery 
      • result in subarachnoid bleeds
      • ↑ risk with genetic disorders
        • adult polycystic kidney disease , Ehlers-Danlos syndrome, Marfan's syndrome
          • collagen diseases weaken artery walls
      • ↑ risk with increasing age, hypertension, smoking, african-americans
  • Presentation
    • with aneurysm rupture
      • symptoms
        • "worst headache in my life"
      • physical exam
        • nuchal rigidity
  • Prognosis, Prevention, and Complications
    • poor
    • complications include further bleeding, vasospasm following blood degradation on the surface of the brain
      • results in yellow color to CSF (xanthochromia)
      • give calcium-channel blockers (eg. nimodipine) to prevent secondary stroke due to vasospasm
Small Vessel Aneurysm
  • Introduction
    • aka Charcot-Bouchard aneurysm
      • MC are lenticulostriate vessels of basal ganglia
      • are intracerebral bleeds
      • ↑ risk with chronic hypertension, diabetes
  • Presentation
    • symptoms
      • not usually associated with headache
      • symptoms mainly by effect of mass-effect on surrounding tissue


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Qbank (1 Questions)

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(M1.NE.17) A 47-year-old male with a medical history significant for hypertension, recurrent urinary tract infections, mitral valve prolapse, and diverticulosis experiences a sudden, severe headache while watching television on his couch. He calls 911 and reports to paramedics that he feels as if "someone shot me in the back of my head." He is rushed to the emergency room. On exam, he shows no focal neurological deficits but has significant nuchal rigidity and photophobia. Of the options below, what is the most likely etiology of this man's headache? Topic Review Topic

1. Migraine
2. Brain Tumor
3. Temporal Arteritis
4. Subarachnoid Hemorrhage
5. Carotid Dissection

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