UMEM Educational Pearls

Category: Neurology

Title: Recognizing Cerebral Aneurysms

Keywords: cerebral aneurysms, aneurysm, ACOM, PCOM, SAH (PubMed Search)

Posted: 8/6/2008 by Aisha Liferidge, MD (Updated: 8/12/2020)
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  • About 2% of the adult population have an asymptomatic cerebral aneurysm.
  • Unruptured aneurysms can cause symptoms such as headache, visual acuity loss, cranial neuropathies (particularly thrid nerve palsy), pyramidal tract dysfunction, and facial pain; these are thought to be due to mass effect on the aneurysm.
  • 20 to 30% of people with a cerebral aneurysm, have multiple aneurysms; Don't miss co-existing aneurysms on CTA or MRI. 
  • The majority of intracranial aneurysms are located in the anterior circulation, most commonly in the Circle of Willis.
  • When localizing aneurysm on CTA and MRI, common sites include

              ---  junction of the anterior communicating artery (ACOM) with the anterior cerebral artery (ACA)

              ---  junction of the posterior communicating artery (PCOM) with the internal carotid artery (ICA)

              ---  bifurcation of the middle cerebral artery (MCA)

References

Singer, et al. "Unruptured Intracranial Aneurysms." November 2007. UptoDate online 16.2.