Distal Lenticulostriate Artery Aneurysm Research Articles

Computed tomography angiography evidence of distal lenticulostriate artery aneurysm

Neurology and Clinical NeuroscienceAccepted Articles PICTURES IN NEUROLOGY Computer Tomography Angiography Evidence of Distal Lenticulostriate Artery Aneurysm Riwaj Bhagat, Corresponding Author Riwaj Bhagat [email protected] Department of Neurology, Boston Medical Center, Boston, MA Correspondence Riwaj Bhagat, MD; Department of Neurology, Boston Medical Center; 85 E Concord St, Boston, MA, 02118; Email: [email protected]Search for more papers by this authorAlexis Clay, Alexis Clay Department of Neurology, Boston Medical Center, Boston, MASearch for more papers by this authorAva Bakhtyari, Ava Bakhtyari Department of Neurology, Boston Medical Center, Boston, MASearch for more papers by this author Riwaj Bhagat, Corresponding Author Riwaj Bhagat [email protected] Department of Neurology, Boston Medical Center, Boston, MA Correspondence Riwaj Bhagat, MD; Department of Neurology, Boston Medical Center; 85 E Concord St, Boston, MA, 02118; Email: [email protected]Search for more papers by this authorAlexis Clay, Alexis Clay Department of Neurology, Boston Medical Center, Boston, MASearch for more papers by this authorAva Bakhtyari, Ava Bakhtyari Department of Neurology, Boston Medical Center, Boston, MASearch for more papers by this author First published: 12 April 2023 https://doi.org/10.1111/ncn3.12717 This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.1111/ncn3.12717. AboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Accepted ArticlesAccepted, unedited articles published online and citable. The final edited and typeset version of record will appear in the future. RelatedInformation

Distal lenticulostriate artery aneurysm in a patient with atherosclerotic intracranial artery occlusion

Distal lenticulostriate artery aneurysm in a patient with atherosclerotic intracranial artery occlusion

脳室内出血にて発症したレンズ核線条体動脈末梢部動脈瘤の1例

脳室内出血にて発症したレンズ核線条体動脈末梢部動脈瘤の1例

Small but Consequential: A Case of Deep Intracerebral Hemorrhage (ICH) Caused by Distal Lenticulostriate Artery Aneurysm (P05.218)

Objective: To report a rare case of hemorrhage stroke caused by a lenticulostriate aneurysmal rupture missed initially by both multidetector cerebral CT angiography and digital subtraction angiography. Background Intracerebral hemorrhage is the deadliest form of stroke. Cerebral angiography is not routinely performed in typical deep intracranial hemorrhage which is often associated with hypertension. In as many as a third of cases of deep ICH, however, there is a treatable underlying structural lesion. We report a case of lenticulostriate artery aneurysmal rupture-a rare subtype of vascular abnormality-which led to a diagnostically challenging but ultimately treatable case of ICH. Design/Methods: Case report. Results: A 41 year-old female presented with headache, diaphoresis, agitation, and left-sided visual-spatial and limb asomatognosia, and hemiparesis. Cerebral CT scan showed an acute intracerebral hemorrhage approximately 28cc in volume centered near the right superior temporal lobe and centrum semiovale. Multidetector CT angiography performed did not reveal definitive evidence of any vascular abnormality. Cerebral catheter-based angiography was also initially negative. On hospital day 4, the patient had increased headache and somnolence with expansion of her intracerebral hemorrhage. Repeat angiogram demonstrated a 3mm distal lenticulostriate aneurysm which was then surgically clipped. The patient underwent extensive physical rehabilitation and was left with residual left arm greater than leg weakness with otherwise good neurological recovery. Repeat cerebral angiogram 3 months later showed resolution of the aneurysm. Conclusions: This is a rare case of intracerebral hemorrhage caused by rupture of a distal lenticulostriate artery aneurysm. After extensive neuroimaging, an underlying aneurysm was discovered. Patients without history of hypertension, who are under the age of 45, and who have atypical hematoma patterns or expansion of ICH after presentation should undergo neuroimaging for underlying structural lesion. Disclosure: Dr. Cai has nothing to disclose. Dr. Han has received personal compensation for activities with Harvard/MIT Health Sciences and Technology-Beth Israel Deaconess Medical Center in collaboration with Pfizer Inc and Merck & Co. Dr. Chou has nothing to disclose.

Distal lenticulostriate artery aneurysm in deep intracerebral haemorrhage

Aneurysms of the distal lenticulostriate artery (LSA) are rare. Only 16 cases have been reported in the literature. Early detection and treatment of these aneurysms is also difficult because of...

Idiopathic distal lenticulostriate artery aneurysm in a child

The authors describe a rare case of idiopathic distal lenticulostriate artery (LSA) aneurysm in a 5-year-old boy who presented in the emergency department with a sudden onset of headache. Admission computed tomography scans revealed an intracerebral hemorrhage in the left caudate nucleus with intraventricular extension. Angiographic studies demonstrated a left medial LSA aneurysm. The patient underwent a left parasagittal frontal craniotomy, the lateral ventricle was accessed via the anterior transcallosal approach, and the aneurysm was removed after sectioning of the parent vessel. The child left the hospital after 5 days; at that time he was asymptomatic and without motor impairment. The optimum treatment of aneurysms involving small perforating arteries is controversial and depends mainly on the causative factors. The pathogenesis and treatment of these unusual aneurysms are discussed.

Distal Lenticulostriate Artery Aneurysm Rupture Presenting as Intraparenchymal Hemorrhage: Case Report

Aneurysms involving the distal lenticulostriate artery branches are a rare cause of spontaneous intracerebral hemorrhage. We report a case of ruptured lenticulostriate aneurysm in an otherwise healthy patient and review the literature on this topic. Computed tomography showed a right basal ganglia hemorrhage in a 44-year-old Native American woman with acute left hemiparesis. Cerebral angiography showed a 2-mm aneurysm in a distal lenticulostriate artery branch. A pterional craniotomy was performed on a delayed basis using computed tomographic angiography and frameless stereotactic guidance. The basal ganglia hematoma was evacuated, and the aneurysm was identified and clipped using microsurgical technique. Because the base of the aneurysm involved a portion of the parent vessel wall, it was wrapped with cotton and reinforced with cyanoacrylate glue. The patient did well after surgery and was discharged to home with outpatient rehabilitation on the third postoperative day. Although intraparenchymal hemorrhages are fairly common, the underlying vascular abnormality is rarely identified. Most are related to hypertensive vascular degeneration, rupture of a Charcot-Bouchard aneurysm, or both. When intracerebral hemorrhage occurs in young patients, however, aggressive investigation is warranted to rule out a structural vascular abnormality.