Cerebral macroaneurysms in a Ghanaian adult population. An autopsy study

An autopsy study of cerebral vessels in 310 Ghanaian adults showed an incidence of macro(berry)aneurysms of 16.6% among 181 hypertensives and 8.5% among 129 normotensives. Hypertension increased the formation and development of intracranial aneurysms. Severe atherosclerosis (Grade 3) was not a common association with aneurysms and there was no increase in aneurysm formation in subjects dying from cerebral haemorrhage. This may be a reflection of the observed low incidence of severe cerebral atherosclerosis in Ghanaians compared to whites and an indication of differences between ethnic groups in the relative importance of the factors that contribute to the formation of aneurysms. Mortality from ruptured aneurysms could not be determined from this study, perhaps because the aneurysms seen were small in size (less than 10 mm diameter) and less likely to rupture and bleed. Multiple aneurysms were an uncommon finding compared to figures quoted in other studies, but in agreement with them the sites of predilection were in the anterior parts of the Circle of Willis; notably the anterior cerebral and anterior communicating arteries.