Clinical features
There are three main presentations of Berry aneurysms:
- 90% present with a subarachnoid haemorrhage
- 7% present with symptoms of a space-occupying lesion:
- internal carotid artery or anterior communicating artery aneurysms may compress:
- pituitary stalk or hypothalamus causing hypopituitarism
- the optic nerve or chiasm producing visual field defects
- basilar artery aneurysm may compress the midbrain or pons to produce limb weakness or impaired eye movements
- posterior communicating artery aneurysm may cause a III nerve palsy
- intracavernous aneurysms may compress the III, IV, VI, trigeminal division of V and trigeminal ganglion to produce ophthalmoplegia and facial pain
- 3% occur as incidental findings at autopsy
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