Abstract
A 52-year-old patient was found to be confused and disoriented with a left hemiparesis. His medical history was remarkable for poorly controlled arterial hypertension and a 40 pack-year smoking history. Non-contrast computed tomography (NCCT) showed a large intracerebral hemorrhage in the right basal ganglia and frontal lobe with intraventricular extension. CT angiography (CTA) was within normal limits. A ventricular drain was inserted on the day after the onset of symptoms. On day 2, the drain was obstructed and intraventricular fibrinolysis was performed. Digital subtraction angiography (DSA) on day 3 showed two small aneurysms of right lenticulostriate arteries. Neither endovascular nor microsurgical treatment appeared feasible without causing further damage. On day 10, the ventricular drain was exchanged for a lumbar drain, and both were removed during the following week. Sequential DSA examinations showed the spontaneous resolution of the aneurysms. Eventually the patient recovered without a neurological deficit. The significance and the management of lenticulostriate aneurysms in the context of hypertensive intracerebral hemorrhage is the main topic of this chapter.
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Colgan, F., Aguilar Pérez, M., Arnold, G., Bäzner, H., Henkes, H. (2020). Lenticulostriate Artery Aneurysm: Arterial Hypertension, Intracerebral Hemorrhage Associated with Lenticulostriate Artery (Charcot Bouchard) Aneurysms – Conservative Management, Spontaneous Aneurysm Resolution, and Good Clinical Outcome. In: Henkes, H., Lylyk, P., Ganslandt, O. (eds) The Aneurysm Casebook. Springer, Cham. https://doi.org/10.1007/978-3-319-70267-4_143-1
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