Rupture of berry aneurysm most commonly results in
**Question:** Rupture of berry aneurysm most commonly results in
A. subarachnoid haemorrhage
B. intracerebral haemorrhage
C. extradural haemorrhage
D. subdural haemorrhage
**Correct Answer:** A. subarachnoid haemorrhage
**Core Concept:**
Berry aneurysms are saccular cerebral aneurysms that occur at the branching points of the cerebral arteries, particularly at the bifurcations of the internal carotid artery and the anterior and posterior communicating arteries. These aneurysms are typically small and are often missed on initial imaging studies. When they rupture, the resulting hemorrhage is typically located in the subarachnoid space, which is a layer of thin, transparent fluid surrounding the brain.
**Why the Correct Answer is Right:**
Subarachnoid haemorrhage (SAH) is the correct answer because berry aneurysms are located at the bifurcations of the cerebral arteries, which are close to the subarachnoid space. When aneurysms rupture, the blood from the ruptured vessel enters the subarachnoid space, causing a subarachnoid haemorrhage.
**Why Each Wrong Option is Incorrect:**
A. Intracerebral haemorrhage (IH): This option is incorrect because berry aneurysms are located in the subarachnoid space, not within the brain parenchyma. When they rupture, the blood enters the subarachnoid space, not the brain parenchyma.
B. Extradural haemorrhage (EH): Extradural haemorrhage occurs when blood accumulates between the dura mater and the arachnoid mater. Since berry aneurysms are located in the subarachnoid space and not the dura mater, this option is incorrect.
C. Subdural haemorrhage (SDH): A subdural haemorrhage occurs when blood accumulates between the dura mater and the arachnoid mater. Similar to extradural haemorrhage, berry aneurysms are located in the subarachnoid space, making this option incorrect.
**Clinical Pearl:**
In cases of subarachnoid haemorrhage, the initial presentation often includes severe headache, nausea, vomiting, and altered mental status. The headache is typically sudden-onset, severe, and described as the worst headache of a patient's life. The headache is often accompanied by neck stiffness, photophobia, phonophobia, and vomiting. These symptoms can alert the clinician to consider subarachnoid haemorrhage in the differential diagnosis.