MRI Cerebral Aneurysm (Berry Aneurysm)

Berry aneurysms, also known as saccular aneurysms, are balloon-like bulges of blood vessels that occur in the brain. They are typically small, rounded, and form at the branching points of arteries. These aneurysms are a significant concern because they can lead to serious or life-threatening bleeding if they rupture.

Causes

The exact cause of berry aneurysms is not fully understood, but they are believed to result from a combination of genetic and environmental factors. Risk factors include:

• Genetic predisposition: Some people inherit a tendency to develop aneurysms.
• High blood pressure: Chronic hypertension can weaken blood vessel walls.
• Smoking: Tobacco use is a significant risk factor.
• Age: They are more common in adults than in children.
• Sex: Females are more likely to develop cerebral aneurysms than males.

Symptoms

Most berry aneurysms do not produce symptoms unless they leak or rupture. When a berry aneurysm ruptures, it leads to a subarachnoid hemorrhage, which can cause sudden symptoms such as:

• Sudden, severe headache (often described as “the worst headache” ever experienced)
• Nausea and vomiting
• Stiff neck
• Sensitivity to light
• Seizures
• Loss of consciousness

Unruptured aneurysms might occasionally cause symptoms if they press on brain structures or nerves, potentially leading to pain above and behind one eye, a dilated pupil, change in vision, or double vision.

Diagnosis

Berry aneurysms are typically diagnosed using imaging techniques that allow the radiologist to see the blood vessels of the brain. Common methods include:

• Computed Tomography (CT) Scan: Especially useful if the aneurysm has ruptured and there is bleeding in the brain.
• Magnetic Resonance Imaging (MRI): Provides high-resolution images of the brain and blood vessels.

Treatment

Treatment for berry aneurysms depends on the size, location, and risk of rupture. Options include:

• Surgical Clipping: This involves placing a tiny metal clip at the base of the aneurysm to isolate it from normal blood circulation, which helps prevent rupture.
• Endovascular Coiling: This minimally invasive procedure involves threading a catheter through the blood vessels to the aneurysm site, where coils are deployed to promote blood clotting and thus seal off the aneurysm.
• Observation: Small aneurysms that are not causing symptoms and have a low risk of rupture may be monitored with regular imaging studies.