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Lenticulostriate Artery Aneurysm: Arterial Hypertension, Intracerebral Hemorrhage Associated with Lenticulostriate Artery (Charcot Bouchard) Aneurysms – Conservative Management, Spontaneous Aneurysm Resolution, and Good Clinical Outcome

  • Frances ColganEmail author
  • Marta Aguilar Pérez
  • Guy Arnold
  • Hansjörg Bäzner
  • Hans Henkes
Living reference work entry

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.

Keywords

Lenticulostriate artery Small aneurysm ICH Anterior circulation Conservative management Spontaneous aneurysm resolution Arterial hypertension 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Frances Colgan
    • 1
    Email author
  • Marta Aguilar Pérez
    • 2
  • Guy Arnold
    • 3
  • Hansjörg Bäzner
    • 4
  • Hans Henkes
    • 2
  1. 1.Christchurch HospitalChristchurchNew Zealand
  2. 2.Neuroradiologische KlinikKlinikum StuttgartStuttgartGermany
  3. 3.Klinik für Neurologie mit Neurophysiologie und SchlaganfalleinheitKlinikum Sindelfingen-BöblingenSindelfingenGermany
  4. 4.Neurologische KlinikKlinikum StuttgartStuttgartGermany

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