Saccular aneurysm
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Saccular aneurysm
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USMLE® Step 1 style questions USMLE
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A 40-year-old man with a history of autosomal dominant polycystic kidney disease presents to the emergency department for evaluation of a sudden onset severe headache. An hour ago, the patient woke up suddenly with an excruciating headache that reached maximum intensity within seconds. His additional medical history includes hypertension and a 20 pack year smoking history. Temperature is 37.0°C (98.6°F), pulse is 110/min, and blood pressure is 150/90 mmHg. On physical examination, nuchal rigidity is noted. A non-contrast CT of the head is obtained and is unremarkable. A lumbar puncture is performed. Which of the following is most likely to be found on further evaluation of this patient’s cerebrospinal fluid?
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Summary
A saccular aneurysm is a round bulge in the wall of a blood vessel, usually an artery. Saccular aneurysms are the most common form of cerebral aneurysm and are caused by a weakening of the vessel wall, which can be caused by aging, high blood pressure, cigarette smoking, and genetic factors. An aneurysm can rupture and cause internal bleeding, which is a serious and life-threatening emergency condition that needs prompt management. Treatment for a saccular aneurysm usually involves open surgery or endovascular repair.