Fusiform Lenticulostriate Artery Aneurysm with Subarachnoid Hemorrhage: The Role for Superselective Angiography in Treatment Planning

Aneurysms of the lenticulostriatal perforating arteries are rare and either involve the middle cerebral artery-perforator junction or are located distally in basal ganglia. We describe a rare ruptured fusiform lenticulostriatal perforating artery aneurysm arising from a proximal M2 MCA branch, disce...

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Bibliographic Details
Published in:Interventional neuroradiology 2010-09, Vol.16 (3), p.259-263
Main Authors: Kochar, P.S., Morrish, W.F., Hudon, M.E., Wong, J.H., Goyal, M.
Format: Article
Language:English
Subjects:
Aneurysm, Ruptured - diagnostic imaging
Aneurysm, Ruptured - surgery
Basal Ganglia Cerebrovascular Disease - diagnostic imaging
Basal Ganglia Cerebrovascular Disease - surgery
Cerebral Angiography - instrumentation
Cerebral Angiography - methods
Humans
Intracranial Aneurysm - diagnostic imaging
Intracranial Aneurysm - surgery
Male
Middle Aged
Original
Preoperative Care
Subarachnoid Hemorrhage - diagnostic imaging
Subarachnoid Hemorrhage - surgery
Tomography, X-Ray Computed
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Summary:Aneurysms of the lenticulostriatal perforating arteries are rare and either involve the middle cerebral artery-perforator junction or are located distally in basal ganglia. We describe a rare ruptured fusiform lenticulostriatal perforating artery aneurysm arising from a proximal M2 MCA branch, discerned on superselective microcatheter angiography, presenting solely with subarachnoid hemorrhage (SAH). A 50-year-old previously healthy man presented with diffuse SAH and negative CT angiogram. Cerebral angiogram demonstrated a 2 mm fusiform aneurysm presumably arising from the right lateral lenticulostriate perforator but the exact origin of the perforator was unclear. Superselective angiography was required to precisely delineate the aneurysm and its vessel of origin and directly influenced treatment planning (surgical trapping). Superselective microcatheter angiography provides both an option for endovascular therapy as well as more accurate delineation for surgical planning for these rare aneurysms.
ISSN:1591-0199
2385-2011
DOI:10.1177/159101991001600305