title: Lenticulostriate aneurysms: a case series and review of the literature.
abstract: BACKGROUND
  Aneurysms of lenticulostriate artery (LSA) perforators are uncommon. There are few data on their natural history, and opinions differ on the treatment strategies.
  
  
  OBJECTIVE
  We report a case series and summarize the most recent literature with current treatment recommendations. We propose an anatomical classification for these entities.
  
  
  METHODS
  A retrospective review of all patients who were diagnosed with an LSA aneurysm on cerebral angiogram was performed. An extensive online literature search was performed to identify other studies reporting on the diagnosis and management of ruptured and unruptured lenticulostriate aneurysms.
  
  
  RESULTS
  48 cases were identified in the literature and reviewed: 27 patients were treated surgically; five cases were treated with endovascular therapy; two cases underwent gamma knife radiosurgery; and 13 cases were managed conservatively. We classified these aneurysms into three types: type 1 describes aneurysms arising from the middle cerebral artery next to a perforating LSA; type 2 is an LSA aneurysm from which the perforating artery or arteries arise-the type 2A subtype is one in which the aneurysm neck incorporates the origin of the perforating arteries and the type 2B describes perforating arteries arising from the dome of the aneurysm; and type 3 describes a fusiform aneurysm beyond the first loop or turn of an LSA.
  
  
  CONCLUSIONS
  LSA aneurysms are rare entities that present several treatment challenges. We have summarized the cumulative experience with these lesions and proposed a classification scheme that has treatment implications.
authors.affiliation: Division of Neurosurgery, Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Jan
authors.initials: J
authors.lastname: Vargas
authors.affiliation: Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Walsh
authors.affiliation: Division of Neurosurgery, Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Raymond
authors.initials: R
authors.lastname: Turner
authors.affiliation: Department of Radiology, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Imran
authors.initials: I
authors.lastname: Chaudry
authors.affiliation: Department of Radiology, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Aquilla
authors.initials: A
authors.lastname: Turk
authors.affiliation: Division of Neurosurgery, Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Spiotta
mesh_terms: D000328:Adult; D020144:Basal Ganglia Cerebrovascular Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D002533:Cerebral Angiography / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
keywords: aneurysm; endovascular