Rupture of lenticulostriate artery aneurysms.
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 follow-up 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 concerning a therapeutic strategy. The authors' experience in 3 reported cases leads them to think that a conservative approach 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.
Departments of Diagnostic and Interventional Neuroradiology and.
Olivier
O
Heck
René
R
Anxionnat
Jean-Christophe
JC
Lacour
Anne-Laure
AL
Derelle
Xavier
X
Ducrocq
Sébastien
S
Richard
Serge
S
Bracard
D000328:Adult; D017542:Aneurysm, Ruptured / Q000150:complications / Q000473:pathology*; D020144:Basal Ganglia Cerebrovascular Disease / Q000150:complications / Q000473:pathology*; D002533:Cerebral Angiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications; D002532:Intracranial Aneurysm / Q000150:complications / Q000473:pathology*; D020300:Intracranial Hemorrhages / Q000209:etiology / Q000473:pathology; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009048:Motor Skills; D010291:Paresis / Q000209:etiology; D007690:Polycystic Kidney Diseases / Q000150:complications; D020127:Recovery of Function; D013060:Speech; D016896:Treatment Outcome