Moyamoya-like disease associated with a lenticulostriate region aneurysm

Abstract

A case of moyamoya-like disease associated with an intracerebral hemorrhage and an unusual aneurysm is reported. The patient's clinical status and the initial and follow-up angiographic appearance of the aneurysm are presented. The etiology of the moyamoya phenomenon and of associated aneurysms is discussed.

Rupture of lenticulostriate artery aneurysms

“…Several cases of spontaneous involution free of hemorrhage recurrence have been described in the lit erature. 12,13,22 The surgical or endovascular treatment of these aneurysms is possible but is difficult and risky be cause the lesions are located deep in the brain and close to sensitive cerebral tissues. 11,43 There is thus no clear con sensus on the best therapeutic strategy for the treatment of ruptured LSA aneurysms, and a conservative approach remains an option.…”

Surgical Treatment of a Lenticulostriate Artery Aneurysm-Case Report-

“…[2][3][4][5][6][7][9][10][11][12][13][14] The six male and seven female patients were aged from 2 months to 69 years (mean 37 years). The aneurysms occurred on the right in five patients and on the left in eight.…”

Intracranial Aneurysms Associated with Moyamoya Disease

“…These changes may result in localized dilatation of the parenchymal vessels, i. e. the abnormal net-like vessels (dilated and tortu ous perforating arteries), the medullary arteries, and the branches of the anterior choroidal and posterior choroidal arteries. 2,6,8,19,21) Pseudoaneurysms are most often located in the abnormal vascular net work, especially in the ganglionic and thalamic region (our Case 1), as well as in the periventricular Saccular aneurysms are most likely caused by hemodynamic stress due to increased blood flow and consequent turbulence in certain portions of the cerebrovascular system, especially in the posterior cir culation.1 '3,5,6,8,9) The development of aneurysms and/or elastic lamina destruction is especially likely in the presence of a media defect in the wall of the affected arteries.5,7) Saccular aneurysms are usually located on the main cerebral arteries and their lep tomeningeal or choroidal branches, and have been found on the following arteries in moyamoya dis ease patients: the ICA, i. e. the cavernous (C3) seg ment or the supraclinoid (C4) segment (the ophthal mic artery origin)," 1,14) the ACA (the A2 segment, the orbitofrontal or the pericallosal artery ori gin)4,21"; the anterior communicating artery 6,21) the MCA (M1 segment),8 the anterior choroidal artery (the origin or distal part),6°19) the PCoA (the ori gin) 1,11,14); the PCA (the P1 segment or distal seg ment)1'6); the lateral posterior choroidal artery6,12,19); the basilar artery (the distal part or the bifurcation site) ' 5,6,8,9,12) and the superior cerebellar artery (the origin) .5,6,9) Aneurysms in the moyamoya disease patients are most often located on the bifurcation site of the basilar artery and on the cavernous seg ment of the ICA.6°8°9) The vertebrobasilar system is involved more often in moyamoya disease patients (43%) than in the general population (5.3-9.6%).g) The MCA, ACA, and anterior communicating ar tery are very rarely involved.") One of our patients had a saccular aneurysm on the middle meningeal artery.…”

“…Intracranial aneurysms have usually been described in individual patients with moyamoya dis ease, 2,8,12,15,17,20,21) as well as in selected cases or in the groups of, predominantly, Japanese patients. ',',',',`) We present our experience with the intracranial aneurysms in a group of 31 patients with moyamoya disease from Yugoslavia.…”