title: Deep Intracerebral Hemorrhage Caused by Rupture of Distal Lenticulostriate Artery Aneurysm : A Report of Two Cases and a Literature Review.
abstract: Intracerebral hemorrhage (ICH) is common among various types of storkes; however, it is rare in young patients and patients who do not have any risk factors. In such cases, ICH is generally caused by vascular malformations, tumors, vasculitis, or drug abuse. Basal ganglia ICH is rarely related with distal lenticulostriate artery (LSA) aneurysm. Since the 1960s, a total of 29 distal LSA aneurysm cases causing ICH have been reported in the English literature. Despite of the small number of cases, various treatment methods have been attempted : surgical clipping, endovascular treatment, conservative treatment, superficial temporal artery-middle cerebral artery anastomosis, and gamma-knife radiosurgery. Here, we report two additional cases and review the literature. Thereupon, we discerned that young patients with deep ICH are in need of conventional cerebral angiography. Moreover, initial conservative treatment with follow-up cerebral angiography might be a good treatment option except for cases with a large amount of hematoma that necessitates emergency evacuation. If the LSA aneurysm still persists or enlarges on follow-up angiography, it should be treated surgically or endovascularly.
authors.affiliation: Department of Neurosurgery, Gangnam Severance Hospital, College of Medicine, Yonsei University, Seoul, Korea.
authors.forename: Yeon Soo
authors.initials: YS
authors.lastname: Choo
authors.affiliation: Department of Neurosurgery, Gangnam Severance Hospital, College of Medicine, Yonsei University, Seoul, Korea.
authors.forename: Yong Bae
authors.initials: YB
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Seoul St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Yong Sam
authors.initials: YS
authors.lastname: Shin
authors.affiliation: Department of Neurosurgery, Gangnam Severance Hospital, College of Medicine, Yonsei University, Seoul, Korea.
authors.forename: Jin Yang
authors.initials: JY
authors.lastname: Joo
keywords: Aneurysm ruptured; Basal ganglia hemorrhage; Lenticulostriate artery