title: Medial lenticulostriate artery aneurysm presenting with isolated intraventricular hemorrhage.
abstract: BACKGROUND
  Isolated intraventricular hemorrhage (IVH) secondary to lenticulostriate artery aneurysm rupture is extremely rare. Thus, the diagnostic imaging modalities and therapeutic interventions utilized in the management of such cases are not clearly defined.
  
  
  METHODS
  Here we describe a case of isolated or primary IVH (PIVH) in a 71-year-old woman presenting with severe headache. Emergent catheter cerebral angiography, performed after nondiagnostic computed tomography angiography (CTA), revealed the bleeding source to be a 4 × 2.6 mm distal medial lenticulostriate artery aneurysm that ruptured directly into the lateral ventricle. The poorly accessible location of the aneurysm for both endovascular and direct surgical treatment argued for conservative management. A good clinical outcome was obtained with rapid angiographic resolution of the ruptured aneurysm.
  
  
  CONCLUSIONS
  Thus, lenticulostriate artery aneurysm rupture must be given diagnostic consideration in cases of isolated IVH. Emergent catheter cerebral angiography should be performed in cases such as this when noninvasive imaging is unrevealing. Conservative management may be a reasonable therapeutic option in patients with this kind of aneurysm, and spontaneous resolution can be observed.
authors: Department of Neurological Surgery, Columbia University Medical Center, NY, USA.
authors: Jason A
authors: JA
authors: Ellis
authors: Randy
authors: R
authors: D'Amico
authors: Dorothea
authors: D
authors: Altschul
authors: Richard
authors: R
authors: Leung
authors: E Sander
authors: ES
authors: Connolly
authors: Philip M
authors: PM
authors: Meyers