Berry aneurysms of the circle of Willis: results of an autopsy study at the University Hospital of the West Indies

ABSTRACT

A detailed study of berry aneurysms of the Circle of Willis, in a consecutive autopsy series, was conducted at the University Hospital during the 10-year period 1973 to 1982. There were 70 patients with berry aneurysms in a total of 3,650 autopsies, giving a prevalence of 1.9 percent. Of 70 cases, 66 had ruptured, all of which were fatal. In 75 percent of cases, the diagnosis was made at post-mortem. Sixty percent of patients had associated hypertension. Physical stress did not appear to be a precipitating factor in causing rupture. Aneurysms occurred equally in men and women but multiple aneurysms occurred most commonly in elderly hypertensive women. The peak age at occurrence was in the third and fourth decades. The majority of aneurysms (91 percent) were located in the anterior circulation, and 37 percent of those that had ruptured were situated in the middle cerebral artery. The results of our study are similar to those found in other autopsy series, thus defying the general opinion that berry aneurysms are uncommon in our population since many of the cases were undiagnosed during life (AU)