Surgical treatment of a lenticulostriate artery aneurysm

Narayan, Prithvi; Workman, Michael J.; Barrow, Daniel L.

doi:10.3171/jns.2004.100.2.0340

Cited by 33 publications

(38 citation statements)

References 8 publications

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“…3D rotational angiography is useful for preoperative planning and intraoperative evaluation of the surgical anatomy. 10) In the present case, we used preoperative 3D-CT angiography for guidance, which clearly indicated the anatomical correlation between the small aneurysm and the ganglia hemorrhage. …”

Section: Discussionmentioning

confidence: 61%

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Surgical Treatment of a Lenticulostriate Artery Aneurysm-Case Report-

Sakai

Mizumatsu

Terasaka

et al. 2005

Neurol. Med. Chir.(Tokyo)

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A previously healthy 61-year-old man presented with basal ganglia hemorrhage caused by rupture of a small aneurysm arising from the distal lenticulostriate artery associated with moyamoya-like disease and manifesting as left hemiparesis and dysarthria. The patient underwent frontotemporal craniotomy. Neck clipping of the aneurysm was performed through the hematoma cavity. He was transferred for rehabilitation with left hemiparesis. Three-dimensional computed tomography angiography was very useful for preoperative planning and evaluation of the anatomical correlation between the aneurysm and the hemorrhage.

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Section: Discussionmentioning

confidence: 61%

“…[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.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of a Lenticulostriate Artery Aneurysm-Case Report-

Sakai

Mizumatsu

Terasaka

et al. 2005

Neurol. Med. Chir.(Tokyo)

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“…Although these modalities offer good sensitiv ity, 29 LSA aneurysms are nonetheless difficult to detect. Of the 46 cases reported in the literature, there were 8 CTA studies 4,7,8,16,19,22,39,43 of which 3 were negative 4,8,19 and 3 MRA studies 17,25,32 of which 1 was negative. 32 All 3 of our patients underwent MRI with an angiographic se quence during the acute phase of the hematoma, but only in 1 case was there evidence of a suspected aneurysm, which was later confirmed on angiography.…”

Section: Discussionmentioning

confidence: 99%

Rupture of lenticulostriate artery aneurysms

Heck¹,

Anxionnat

Lacour

et al. 2014

JNS

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The authors report on 3 rare cases of ruptured lenticulostriate artery (LSA) aneurysms that were heralded by deep cerebral hematomas. The hematomas were unilateral in 2 cases and bilateral in 1; in the bilateral case, only a single LSA aneurysm could be identified on the right side of the brain. Because of their small size (≤ 2 mm), fusiform aspect, and deep location within the brain, all of the aneurysms were treated conservatively. There was no hemorrhage recurrence, and followup angiography demonstrated spontaneous thrombosis in 2 of the 3 cases. The clinical course was favorable in 2 of the 3 patients. The course in the patient with the bilateral hematoma was marked by an ischemic event after the initial episode, resulting in an aggravation of deficits. The cause of this second event was uncertain.Because our knowledge about the natural history of LSA aneurysms is incomplete, there is no consensus con cerning a therapeutic strategy. The authors' experience in 3 reported cases leads them to think that a conservative ap proach involving close angiographic monitoring may be proposed as first-line treatment. If the monitored aneurysm then persists or grows in size, its occlusion should be considered. Nonetheless, other studies are needed to further strengthen the legitimacy of this strategy. (http://thejns.org/doi/abs/10.3171/2013.8.JNS13608) key WOrDs • lenticulostriate artery • aneurysm • cerebral hemorrhage • intracerebral hematoma • stroke • vascular disorders Abbreviations used in this paper: AVM = arteriovenous malfor mation; CTA = CT angiography; IVH = intraventricular hemor rhage; LSA = lenticulostriate artery; MRA = MR angiography; mRS = modified Rankin Scale; SAH = subarachnoid hemorrhage.

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“…[1][2][3][4][5] The natural history of these aneurysms is, therefore, largely uncertain. Predisposing factors include hypertension, arteriovenous malformation, infection, systemic lupus erythematosus, and Moyamoya disease.…”

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confidence: 99%

“…Predisposing factors include hypertension, arteriovenous malformation, infection, systemic lupus erythematosus, and Moyamoya disease. 4,5 The inherent difficulty in surgical treatment of these aneurysms, due to deep location, small size, and sometimes unfavorable morphology, is compounded in the setting of Moyamoya disease by vessel hemodynamic fragility. 2,[6][7][8] We discuss the utility of functional testing with amobarbital (Amytal) before endovascular embolization with n-BCA of an unruptured distal LSA aneurysm in the setting of Moyamoya disease.…”

mentioning

confidence: 99%

Embolization of an Unruptured Distal Lenticulostriate Aneurysm Associated with Moyamoya Disease

Harreld¹,

Zomorodi²

2010

AJNR Am J Neuroradiol

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SUMMARY: Lenticulostriate aneurysms are rare and usually present with intracranial hemorrhage, limiting understanding of their natural course. We describe an unusual case of an unruptured rapidly growing distal LSA aneurysm in the setting of Moyamoya disease, successfully embolized with n-BCA following functional neurologic testing with amobarbital.ABBREVIATIONS: n-BCA ϭ n-butyl cyanoacrylate; MCA ϭ middle cerebral artery; ACA ϭ anterior cerebral artery; LSA ϭ lenticulostriate artery; DSA ϭ digital subtraction angiography R eports of LSA aneurysms are rare in the literature, numbering in the low 20s, with most cases diagnosed following intracranial hemorrhage due to rupture. [1][2][3][4][5] The natural history of these aneurysms is, therefore, largely uncertain. Predisposing factors include hypertension, arteriovenous malformation, infection, systemic lupus erythematosus, and Moyamoya disease. 4,5 The inherent difficulty in surgical treatment of these aneurysms, due to deep location, small size, and sometimes unfavorable morphology, is compounded in the setting of Moyamoya disease by vessel hemodynamic fragility.2,6-8 We discuss the utility of functional testing with amobarbital (Amytal) before endovascular embolization with n-BCA of an unruptured distal LSA aneurysm in the setting of Moyamoya disease. Case ReportA 35-year-old woman with Moyamoya disease and a history of 2 ruptured aneurysms was referred for follow-up. Physical examination demonstrated mildly decreased strength on the left, decreased bilateral upper quadrant peripheral vision and right-sided hearing loss, and slightly unsteady gait. Reflexes and sensory examination findings were normal. Mental status examination demonstrated normal higher cortical and language function. The findings of the remainder of her physical examination and medical history were unremarkable.CT angiography demonstrated a 3-mm right distal LSA aneurysm and a Moyamoya vascular pattern, with numerous small-vessel collaterals supplying the MCA and ACA territories bilaterally. A right frontal pericallosal artery branch aneurysm clip was present. Conventional angiography 1 month later again demonstrated a right LSA aneurysm, now measuring 4.2 ϫ 3.9 ϫ 3.8 mm with a 1.8-mm neck, and collateral supply to a posterior frontal MCA branch. She was referred for endovascular treatment 10 days later.A 6F Guider catheter (Boston Scientific, Fremont, California) was positioned in the distal right internal carotid artery, through which an Excelsior SL-10 microcatheter (Target Therapeutics/Boston Scientific, Fremont, California) was advanced over a Synchro-10 microguidewire (Boston Scientific, Natick, Massachusetts) and positioned proximal to the aneurysm within the involved LSA. Superselective contrast injection demonstrated a 4.4-mm LSA aneurysm, retrograde filling of a dilated right posterior frontal MCA branch collateral from the aneurysm, and faint basal ganglia blush (Fig 1A). We administered 25 mg of Amytal via the microcatheter; subsequent neurologic examination demonstrated left faci...

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Surgical treatment of a lenticulostriate artery aneurysm

Cited by 33 publications

References 8 publications

Surgical Treatment of a Lenticulostriate Artery Aneurysm-Case Report-

Surgical Treatment of a Lenticulostriate Artery Aneurysm-Case Report-

Rupture of lenticulostriate artery aneurysms

Embolization of an Unruptured Distal Lenticulostriate Aneurysm Associated with Moyamoya Disease

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