h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

This is an excellent, comprehensive article on this subject. There's not a lot more I can think of to say.

Abdominal aortic aneurysm (non-ruptured)- clinically this could be detected as a pulsatile, expansile abdominal mass. However, the pulsatile nature of the aneurysm can be lost if there is marked organising thrombus formation. It also causes lumbar back pain.

Aortic dissection - you quite rightly stated that this can be associated with Marfan's syndrome. Aortic dissection can actually be the presenting feature in (young) people that were unknown to have Marfan's syndrome. In such cases, genetic screening is advised for relatives of the affected person for defects of the fibrillin gene.
Aortic dissection in elderly people is due to age- and hypertension-related degeneration of the collagen fibres of the tunica media, with aggregation of myxoid material in the stroma. The condition is called "cystic medionecrosis", which is a misnomer because it's neither cystic nor necrotic in its pathogenesis. Interestingly, some people have suggested that atherosclerosis of the aorta may have a PROTECTIVE effect against the development of aortic dissection, because of the scarring effect that it has in the aortic wall (in contrast to its role in the development of fusiform aneurysms).

Isolated coronary artery dissection is also a related entity, which can be a cause of sudden cardiac death in otherwise healthy young adults. Collagen gene defects also need to be screened for in relatives of these individuals as well, but the association is not so clear-cut. Some cases of coronary artery dissection have been described in relation to eosinophiic inflammation of the vessel, perhaps as part of the Churg-Strauss syndrome (a type of vasculitis - inflammation of blood vessels - that's related to asthma).

Non-ruptured Berry aneurysms of the posterior communicating artery of the Circle of Willis in the brain may present with a sudden onset of ptosis (drooping of the eyelid), possibly also with dilation of the pupil and paralysis of eye movements, frequently also with headaches. The ptosis and eye symptoms are caused by the aneurysm compressing the oculomotor nerve (third cranial nerve) on its way from the brainstem to the eye.

Glad you liked the article, its hard sometimes to make sure its comprehensive and includes everythign it should espeically in reference to other conditions that it can be associated with etc., without making it too complicated and unreadable by anyone less they've got a lot of experiance of studying the subject... Hopefully its balanced enough that anyone can read it and get a clue as to what its all about, but not so simple as to put off anyone who already knows a fair bit a pathology/bioogy

Thank you for the interesting article on Aneutysms, my husband(age 67 ) has an aortic one in his chest that is 5cm and his doctor told him there was nothing that could be done,thankfully we have found another doctor who is seeing him on Feb7. I now understand the problem much better,thank you h2g2 from Australia!!

Glad to be of help And I hope your Husband recovers quickly and without complication

Sorry for delay in responding but the 'puter wouldn't let me and I'm technically challenged!!My husband has just seen a specialist (a Mr Michael Denton,FRCAS) and he said that tho the aneurysm was a bit close to his r.kidney it may be possible to do something with it!He will see him again in September after another angiogram. Thanks again for your good article it put things into perspective for me and I'm not the brightest star on the Christmas tree!! Cheers,Pam. (will this do?!)