Korean J Cerebrovasc Surg.  2011 Sep;13(3):129-136.

Distal Lenticulostriate Artery Aneurysm Presenting With Spontaneous Intracerebral and Intraventricular Hemorrhage: A Case Report and a Review of the Literature

• Sung JK
• Koh HS
• Kang CW
• Kwon HJ
• Youm JY
• Kim SH

Abstract

The authors report here on a rare case of aneurysm involving the distal lenticulostriate artery (LSA) in a 66-year-old man who presented with intracerebral hemorrhage (ICH) in the right basal ganglia and also intraventricular hemorrhage (IVH). Three-dimensional computed tomography angiography (3D-CTA) and conventional cerebral angiography showed a 4 mm, round-shaped aneurysm in the right distal LSA and this was combined with moyamoya-like disease. We performed proximal clipping of the aneurysm using a microsurgical technique and we evacuated the hematoma. After the operation, there was recurrent bleeding around the operation site and hydrocephalus gradually developed, and we implanted a ventriculo-peritoneal (V-P) shunt. The patient did well after the final shunt surgery and rehabilitation. Presently, he has no motor weakness or significant neurologic deficit, but mild cognitive dysfunction remains. When spontaneous ICH occurs in an unusual site, a thorough investigation is important to rule out a structural vascular abnormality.

Keyword

Aneurysm; Distal lenticulostriate artery; Hemorrhage

MeSH Terms

Aged
Aneurysm
Angiography
Arteries
Basal Ganglia
Cerebral Angiography
Cerebral Hemorrhage
Hematoma
Hemorrhage
Humans
Hydrocephalus
Neurologic Manifestations