AR : Embolization of an unruptured distal lenticulostriate aneurysm associated with moyamoya disease

SUMMARY: Lenticulostriate aneurysms are rare and usually present with intracranial hemorrhage, limiting understanding of their natural course. We describe an unusual case of an unruptured rapidly growing distal LSA aneurysm in the setting of Moyamoya disease, successfully embolized with n-BCA following functional neurologic testing with amobarbital. ABBREVIATIONS: n-BCA n-butyl cyanoacrylate; MCA middle cerebral artery; ACA anterior cerebral artery; LSA lenticulostriate artery; DSA digital subtraction angiography Reports of LSA aneurysms are rare in the literature, num-bering in the low 20s, with most cases diagnosed follow-ing intracranial hemorrhage due to rupture.1-5 The natural history of these aneurysms is, therefore, largely uncertain. Pre-disposing factors include hypertension, arteriovenousmalfor-mation, infection, systemic lupus erythematosus, and Moya-moya disease.4,5 The inherent difficulty in surgical treatment of these aneurysms, due to deep location, small size, and some-times unfavorable morphology, is compounded in the setting ofMoyamoya disease by vessel hemodynamic fragility.2,6-8W