A 79-year-old woman was driving her automobile when she had a sudden, severe headache. She drove to a service
station, stopped the vehicle, and slumped over the wheel. She was taken to the emergency department, where she
remained comatose and died 6 hours later. The gross appearance of the brain at autopsy is shown in the figure. What is
the most likely diagnosis?
A. Hemorrhage in a glioblastoma multiforme B. Thromboembolization with cerebral infarction C. Tearing of the bridging veins D. Rupture of a berry aneurysm E. Hyaline arteriolosclerosis with hemorrhage
Rupture of a berry aneurysm-(d) the figure shows an aneurysm in the circle of willis and extensive subarachnoid hemorrhage. the hemorrhageoccurs at the base of the brain because berry aneurysms involve the circle of willis and its branches. the vasospasmcaused by the leakage of blood can lead to ischemia, which complicates the course further. a glioblastoma often hasextensive necrosis and some hemorrhage, but the blood remains intraparenchymal. thromboembolic infarctions can behemorrhagic because the embolus does not completely occlude the vessel, but the hemorrhage is localized. rupture ofbridging veins occurs at the vertex beneath the dura, producing a subdural hematoma. hypertensive hemorrhages mostoften occur in the basal ganglia, the pons, or the cerebellum from rupture of small arteries in hyaline arteriolosclerosis, andthe blood typically remains intraparenchymal.bp7 816818bp8 866867pbd7 13661368pbd8 12971298