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Idiopathic distal lenticulostriate artery aneurysm in a child

Hamilton Matushita1, Robison Luis Oliveira Amorim, Wellingson Silva Paiva

  • 1Pediatric Neurosurgery, Department of Neurosurgery, University of São Paulo Medical School, São Paulo, Brazil. neurosp@uol.com.br

Journal of Neurosurgery
|May 10, 2008
PubMed

Insights

A rare idiopathic distal lenticulostriate artery (LSA) aneurysm caused a brain hemorrhage in a 5-year-old boy. Surgical removal of the LSA aneurysm led to a full recovery without motor deficits.

Area of Science:

  • Neurology
  • Neurosurgery
  • Pediatric Neurology

Background:

  • Idiopathic distal lenticulostriate artery (LSA) aneurysms are rare vascular malformations.
  • Intracerebral hemorrhage secondary to LSA aneurysm rupture presents a significant clinical challenge, particularly in pediatric cases.

Observation:

  • A 5-year-old boy presented with sudden severe headache, indicative of acute neurological distress.
  • Computed tomography revealed an intracerebral hemorrhage in the left caudate nucleus with intraventricular extension.
  • Angiography confirmed a left medial lenticulostriate artery aneurysm as the source of bleeding.

Findings:

  • Surgical resection of the LSA aneurysm was successfully performed via a left parasagittal frontal craniotomy.
  • The surgical approach involved accessing the lateral ventricle through an anterior transcallosal route.
  • The parent vessel was sectioned to achieve complete aneurysm removal.

Implications:

  • Successful surgical management of pediatric LSA aneurysms can lead to excellent clinical outcomes.
  • This case highlights the importance of prompt diagnosis and aggressive surgical intervention for ruptured LSA aneurysms.
  • Further research into the pathogenesis and optimal treatment strategies for aneurysms of small perforating arteries is warranted.

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