title: The "Spot Sign" secondary to a ruptured lenticulostriate artery aneurysm.
abstract: The "Spot Sign" is a well-recognized radiographic predictor for hematoma expansion in patients with intracerebral hemorrhages. Although the exact underlying pathophysiology is unknown, it is generally assumed to be the site of blood vessel rupture and contrast extravasation. We report a case of an 81-year-old man who presented with right basal ganglia hemorrhage and the "Spot Sign" on computed tomography angiography. Conventional angiography subsequently revealed a lenticulostriate artery aneurysm within the hematoma, which was treated with surgical clipping. This case demonstrates that rare entities such as lenticulostriate aneurysms must be kept in the differential diagnoses in order to optimize patient management and improve clinical outcome.
authors.affiliation: Department of Neurosurgery, Rush University Medical Center, Chicago, IL 60612, USA.
authors.forename: Lee A
authors.initials: LA
authors.lastname: Tan
authors.affiliation: Department of Neurosurgery, Rush University Medical Center, Chicago, IL 60612, USA. Electronic address: manish_kasliwal@rush.edu.
authors.forename: Manish K
authors.initials: MK
authors.lastname: Kasliwal
authors.affiliation: Department of Neurosurgery, Rush University Medical Center, Chicago, IL 60612, USA.
authors.forename: Andrew K
authors.initials: AK
authors.lastname: Johnson
authors.affiliation: Department of Neurosurgery, Rush University Medical Center, Chicago, IL 60612, USA.
authors.forename: Demetrius K
authors.initials: DK
authors.lastname: Lopes
mesh_terms: D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging*; D001158:Arteries / Q000473:pathology; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D006406:Hematoma / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Intracerebral hemorrhage; Lenticulostriate artery aneurysm; Spot sign