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Aneuysms- Pathology

Definition: Congenital or acquired weakness of vessel wall media, resulting in a localized dilation or out pouching.
The bulge in the aneurysm may burst and death may occur any time.

1. Atherosclerotic aneurysms:
  • Weakening of media secondary to atheroma formation
  • Occur in the abdominal aorta below the real arteries
  • Associated with hypertension
  • Half of aortic aneurysms > 6cm in diameter will rupture within 10 years
2.Aortic dissecting aneurysms
  • Its due to cystic medial necrosis of tunica media.
  • Blood from the vessel lumen enters the intimal tear and dissects through the layers of media.
  • It presents with severe tearing pain.
  • It may compress and obstruct the aortic the aortic branches (eg- renal or coronary arteries)
  • HTN and Marfan syndrome are predisposing factors.
3. Syphilitic aneurysms:
  • Involves ascending aorta
  • Syphilitic (leutic) aortitis causes an obliterative endarteritis of the vasa vasoram. Leading to ischemia and smooth muscle atrophy of aortic media.
  • May dilate the aortic valve ring causing aortic insufficiency.
4. Berry aneurysm:
  • Congenital aneurysm of Circle of Willis.
5. Micro aneurysms: Small aneurysms commonly seen in HTN (hypertension) and diabetes.

6. Mycotic aneurysms: aneurysm usually due to bacterial infections.

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