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http://dx.doi.org/10.3340/jkns.2015.58.5.471

Deep Intracerebral Hemorrhage Caused by Rupture of Distal Lenticulostriate Artery Aneurysm : A Report of Two Cases and a Literature Review  

Choo, Yeon Soo (Department of Neurosurgery, Gangnam Severance Hospital, College of Medicine, Yonsei University)
Kim, Yong Bae (Department of Neurosurgery, Gangnam Severance Hospital, College of Medicine, Yonsei University)
Shin, Yong Sam (Department of Neurosurgery, Seoul St. Mary Hospital, College of Medicine, The Catholic University of Korea)
Joo, Jin Yang (Department of Neurosurgery, Gangnam Severance Hospital, College of Medicine, Yonsei University)
Publication Information
Journal of Korean Neurosurgical Society / v.58, no.5, 2015 , pp. 471-475 More about this Journal
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.
Keywords
Aneurysm ruptured; Basal ganglia hemorrhage; Lenticulostriate artery;
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