A Rare Case of Lenticulostriate Artery Aneurysm Presenting with Subarachnoid Haemorrhage | Chapter 3 | Medical Science: Trends and Innovations Vol. 1

Lenticulostriate perforating artery aneurysms are rare. This is a report of a rare case of LSA aneurysm presenting with SAH who was successfully managed conservatively. Lenticulostriate artery (LSA) aneurysms are endarteries, small and fragile and supply internal capsule and basal ganglia and LSA aneurysms may be saccular or fusiform and commonly present with basal ganglia hemorrhage. This report presents a 60 year old female without any history of comorbid illness presented with sudden onset severe headache followed by altered sensorium and vomiting. There was no history of seizures or head injury. On examination her Glasgow coma scale (GCS) was 12 and had left hemiparesis (power of 2/5). Tablet nimodepine 60 mg was given every 4th hourly through nasogastric tube to prevent any vasospasm secondary to SAH patient had already developed hemiparesis though there were no demonstrable infarcts on CT. However, treatment of LSA aneurysms is still controversy because of small patient numbers. Because of the relatively inaccessible location of these lesions for direct surgical or endovascular occlusion, conservative management may be a therapeutic option in patients with LSA aneurysm, and spontaneous resolution can be observed. It is concluded that LSA aneurysms are as such rare and presenting as SAH is further a rare entity. Around 29 cases of aneurysm arising from LSA have been reported. Catheter angiography may be helpful in patients with SAH to identify these rare etiological causes.

 

Author (s) Details

 

Raghavendra Bakki Sannegowda
Department of Neurology, Father Muller Medical College, Karnataka, India.

 

Trilochan Srivastava
Department of Neurology, SMS Medical College Hospital, Jaipur, Rajasthan, India.

 

Bhawna Sharma
Department of Neurology, SMS Medical College Hospital, Jaipur, Rajasthan, India.

 

Tarun Mathur
Department of Neurology, SMS Medical College Hospital, Jaipur, Rajasthan, India

 

Borislav Atzev
Department of Neurology, SMS Medical College Hospital, Jaipur, Rajasthan, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v1/3707