Rupture of berry aneurysm – a preventable fatality

ted12-Jun-2021 Berry aneurysm is one of the commonest cause of subarachnoid haemorrhage commonly seen in bifurcation sites of circle of Willis. Unruptured aneurysms are asymptomatic and are usually missed unless suspected, even with radiological methods. Common risk factors include Autosomal Dominant Polycystic Kidney Disease (AD-PKD), smoking, hypertension, connective tissue disorders etc. Hereby we present a 37-year old hypertensive male who was taken to a primary health care centre due to unresponsiveness. He was suspected to be having intracranial haemorrhage and referred to a tertiary hospital wherein he was declared brought dead. Dissection of cranial cavity revealed rupture of berry aneurysm in the left posterior communicating artery of circle of Willis. Intracerebral haemorrhage was noted in the left internal capsule. Pontine haemorrhage was noted. Cause of death was determined to be intracranial haemorrhage secondary to rupture of berry aneurysm. Ruptured berry aneurysms are associated with high mortality and morbidity rates. Screening and early diagnosis can prevent complications associated with rupture. Screening is recommended for high risk groups. Cessation of smoking and control of hypertension can prevent rupture and prevent this fatality.