Aneurysm of Distal Medial Lenticulostriate Artery: Report of 2 Cases
| Autor: | Akihiko Hino, Shigeomi Yokoya, Hideki Oka, Naoto Shiomi, Masahito Fujimoto |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry medicine.medical_treatment Caudate nucleus Clipping (medicine) medicine.disease Medial Lenticulostriate Artery 03 medical and health sciences 0302 clinical medicine Intraventricular hemorrhage Aneurysm Hematoma 030220 oncology & carcinogenesis medicine.artery cardiovascular system medicine Anterior cerebral artery Surgery cardiovascular diseases Neurology (clinical) Radiology business 030217 neurology & neurosurgery Cerebral angiography |
| Zdroj: | World Neurosurgery. 143:219-222 |
| ISSN: | 1878-8750 |
| Popis: | Background Aneurysms originating from the distal portion of the lenticulostriate artery (LSA) are uncommon. Distal medial LSA (MLSA) aneurysms are particularly uncommon when compared with distal lateral LSA aneurysms, and their clinical features are unclear. Here, we present 2 patients with aneurysms of the distal MLSA who exhibited hemorrhages of the caudate nucleus and intraventricular region (intraventricular hemorrhage [IVH]). Case Description Patient 1 is a 50-year-old woman who was admitted to our hospital because of a hemorrhage in the left caudate nucleus and ventricles. She underwent external ventricular drainage (EVD). Cerebral angiography (CAG) performed on hospital day 24 showed an aneurysm located in the distal portion of the MLSA; however, CAG performed on admission revealed no abnormal vessels. We excised the aneurysm using a transcallosal-transventricular approach. Patient 2 is an 88-year-old woman who was admitted to our hospital with a right caudate nucleus hematoma and a dense IVH. She underwent emergent EVD. CAG demonstrated a 2.5-mm aneurysm in the distal MLSA, and a 6-mm aneurysm which originated from the right horizontal portion of the anterior cerebral artery (A1)–MLSA bifurcation aneurysm. We performed direct clipping of the A1-MLSA bifurcation aneurysm with proximal ligation of the distal MLSA aneurysm. Conclusions We should consider the possibility of a ruptured distal MLSA aneurysm when diagnosing a patient with IVH—with or without a caudate nucleus hematoma. Repeated imaging evaluations may be necessary to find the lesion. |
| Databáze: | OpenAIRE |
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