Abstract
This case report details the pathological findings of a vessel wall identified as the bleeding point for intracranial hemorrhage associated with Moyamoya disease. A 29-year-old woman experienced intracranial hemorrhage unrelated to hyperperfusion following superficial temporal artery-middle cerebral artery bypass surgery. A pseudoaneurysm on the lenticulostriate artery (LSA) was identified as the causative vessel and subsequently excised. Examination of the excised pseudoaneurysm revealed a fragment of the LSA, with a disrupted internal elastic lamina and media degeneration. These pathological findings in a perforating artery, akin to the circle of Willis, provide insights into the underlying mechanisms of hemorrhage in Moyamoya disease.
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Data sharing is not applicable to this article as no new data were created or analyzed in this study.
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Abbreviations
- LSA:
-
Lenticulostriate artery
- STA-MCA bypass:
-
Superficial temporal artery-middle cerebral artery bypass
- DSA:
-
Digital subtraction angiography
- SMA:
-
Smooth muscle actin
- STS-MIP:
-
Sliding thin-slab maximum intensity projection
- MRA:
-
Magnetic resonance angiography
- CT:
-
Computed tomography
- H-E:
-
Hematoxylin and eosin
- MCA:
-
Middle cerebral artery
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Atsushi Hashio: conceptualization and writing the original draft; Eika Hamano: conceptualization, supervision, and writing the original draft; Saya Ozaki: conceptualization and supervision; Kinta Hatyakeyama: pathological analysis and review; Yoshihiko Ikeda: pathological analysis and review; Akihiro Niwa: writing, review, and editing; Naoto Yamada: writing, review, and editing; Taichi Ikedo: writing, review, and editing; Kiyofumi Yamada: writing, review, and editing; Hirotoshi Imamura: writing, review, and editing; Hisae Mori: writing, review, and editing; Koji Iihara: writing, review, and editing; Hiroharu Kataoka: supervision, writing, review, and editing.
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Hashio, A., Hamano, E., Ozaki, S. et al. Pathological changes in the lenticulostriate artery indicate the mechanisms leading to intracranial hemorrhage in Moyamoya disease: a case report. Acta Neurochir 166, 116 (2024). https://doi.org/10.1007/s00701-024-05992-5
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DOI: https://doi.org/10.1007/s00701-024-05992-5