Abstract

FONTANA, Horacio et al. La circulación cerebral en condiciones patológicas IV: El aneurisma. Rev. argent. neurocir. [online]. 2008, vol.22, n.1. ISSN 1850-1532.

The investigations about the dimensions of cerebral aneurysms are not precise because of the different methodologies that have been employed and the absence of their standardization, so as the inherent difficulties. There is plenty of classifications by size of the cerebral aneurysms with different cutpoints after the goals of the authors (determination of the size of rupture or of the surgical risk are the most searched). The consequent concepts of those criterions have then, relative value. The morphologic characterization of aneurisms iniciated by German and Black almost sixty years ago may be a valid alternative to employ in practice as a complement of the dimensions. The aspect ratio points in this sense but could be insufficient. The shape of the sack has been given little attention in practice, except for multilocularity, in surgical decision making. We think that incipient aneurysms should have a semiesferic shape and that the neck apparition possibly generates changes in the sack, that makes it to change to an irregular ellipsoid. Loculation definitely gives the terminal shape to the aneurism. If the shape would indicate the developement stadium of the aneurysm, it could became an issue that deserves to be analyzed in detail. Angio CT could be of great help to this aim. The iniciation, growth and rupture of a cerebral aneurysm could be related to some static factors such as: hypertension, increase of cerebrovascular resistance and the increase of arterial pulsatility.

Keywords : Cerebral aneyrisms; Pathophysiology.

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