Aneurysm of lenticulostriate artery in a patient presenting with hemorrhage in the caudate nucleus and lateral ventricle-delayed appearance and spontaneous resolution

Abstract

Background:An aneurysm of distal lenticulostriate artery is very rare. The natural course and management of this rare aneurysm are not clear.Case Description:An 81-year-old woman developed consciousness disturbance. Computed tomography revealed hemorrhage in the right caudate nucleus and lateral ventricles. Three-dimensional computed tomographic angiography demonstrated only an aneurysm at the basilar artery. On angiography, on the sixth day, an aneurysm at the right lenticulostriate artery was demonstrated. Then, the aneurysm disappeared on three-dimensional computed tomographic angiography on the 15th day. Subsequent radiological examinations revealed no vascular anomaly in the right lenticulostriate artery.Conclusion:An aneurysm at this location can show dynamic changes based on radiological findings. Close radiological observation is necessary.

Charcot-Bouchard Aneurysm Diagnosed with CTA and MRA

“…To date, only approximately 60 cases of Charcot-Bouchard aneurysms are reported. They mostly present at a younger age with a mean of 41.9 years [ 1 ], and not all patients are hypertensive. The primary type of distal lenticulostriate aneurysms is probably dissecting or pseudo-aneurysms, but true saccular aneurysms exist [ 1 ].…”

“…They mostly present at a younger age with a mean of 41.9 years [ 1 ], and not all patients are hypertensive. The primary type of distal lenticulostriate aneurysms is probably dissecting or pseudo-aneurysms, but true saccular aneurysms exist [ 1 ]. They mostly lead to solitary hematomas in the basal ganglia mimicking hypertensive hemorrhage [2].…”

“…This so-called spot sign is important to recognize, as it indicates active bleeding and predicts rapid hematoma expansion. The lesion can also be shown on MRA [ 1 ] or contrast-enhanced T1-weighted MR, In some cases, however, cross-sectional imaging may fail to display the lesion, which makes catheter angiography the diagnostic standard of reference [ 1 ].…”

“…Treatment of Charcot aneurysms would be indicated if the aneurysm is saccular or exceeds 5 mm [ 1 ]. Treatment options include surgery or embolisation.…”

A Patient with a Distal Medial Lenticulostriate Artery Aneurysm and Intraventricular Hemorrhage Treated by Endovascular Treatment

“…Subsequently, sepsis triggered by pneumonia To our knowledge, seven patients with distal mLSA aneurysms, including the present patient, have been reported ( Table 1). [8][9][10][11][12][13] Their ages varied from 5 to 81 years. Of the seven patients, five presented with PIVH, and most of them had idiopathic aneurysms without underlying disease.…”