Aneurysm

Aneurysm

Definition: - Abnormal localized dilatation of arterial wall

Causes: - Lesions which weaken media of arteries, including:-
1) Syphilis→ Aneurysm in thoracic aorta
2) Atherosclerosis →abdominal aorta aneurysm
3) Vasculitis as polyarteritis nodosa
4) Congenital aneurysm.
TYPES OF ANUERYSM
A- According to site:
1-Aortic aneurysm →thoracic or abdominal aorta
2- Cerebral aneurysm
3- Peripheral aneurysm
4- Cardiac aneurysm
B- According to the cause:
1- Syphilitic
2- Atherosclerotic.
3- Dissecting.
4- Congenital aneurysm
5- Mycotic.

C- According to the shape of the dilated segment:

1- Saccular aneurysm

Localized spherical (balloon-shaped)

dilatation of arterial wall at one side
(NOT including the whole circumference of the affected
segment)

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2- Fusiform
Spindle shaped enlargement
in a segment of arterial wall
{including whole circumference of the affected segment.}
3- Cylindrical
long part of the affected artery is dilated
D- According to aneurysm wall
A) True aneurysm → the wall of aneurysm is a part of arterial wall
B) False aneurysm →Lesion is not part of arterial wall, it communicates with the
arterial lumen and pulsating with the
arterial pulse, Including ➔
1) Simple false aneurysm
** Organized hematoma from trauma➔
communicating with artery though small
opening
** It's pulsating with it

2) Cirsoid aneurysm (common in scalp)

Arterio-venous fistula (A.V.F) →
formed of mass of
intercommunicating vessels.

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E-According to etiology :-

Type 1- Atherosclerotic 2- Mycotic 3- Congenital

Site Abdominal aorta & the cerebral & Cerebral arteries

main aortic branches mesenteric arteries →circle of Willis (Berry
aneurysm )

Cause Atherosclerosis Emboli containing Congenital weakness of

low virulent the media
organisms in case of
(S.B.E) & P.A.N

pathogenesis Inflammation of
vascular wall
→fibrosis & dilatation

Characters Dilatation of whole Saccular small

(Shape) circumference of affected aneurysms
arterial segment →
(fusiform aneurysm).

Diagram

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Syphilitic Dissecting

Cause Treponema Medial necrosis &

Atherosclerosis

Site Ascending aorta & aortic arch Aorta

(Rich in lymphatics & rich in Treponema
organisms)

Pathogenesis Syphilitic aortitis starts at adventitia Blood pass through fissured

involving vasa vasora→End arteritis
obliterans →ischemia & inflammation→
scarring (fibrosis) →weakness of
vascular wall
atherosclerosis (atheroma) ➔
splits media into 2 layers
2- The dissecting blood may
pass to the aortic branches
→compress their exits →
ischemia

Morphology 1) Saccular or fusiform aneurysm

→occurs in 3ry stage syphilis.
2) The aneurysm enlarged →extends to
aortic valve ring → aortic insufficiency→
Left Ventricular overload → massive
cardiac hypertrophy (Cor-bovinum)

Syphilitic aneurysm Dissecting aneurysm

Complications of aneurysm
1- Rupture→ hemorrhage
2- Stasis →Thrombus formation→embolism
3- Pressure atrophy on surrounding

CVS 1 4
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