Ruptured Lenticulostriate Artery Aneurysm Associated with Moyamoya Disease: A Case Report and Literature Review.

INTRODUCTION: Clinically, ruptured lenticulostriate artery (LSA) aneurysm associated with moyamoya disease (MMD) is rare but represents a potential hemorrhagic risk. Its optimal management remains unknown. CASE DESCRIPTION: A 66-year-old woman developed a left basal ganglia hemorrhage with intraventricular extension secondary to an MMD-associated distal LSA aneurysm that was subsequently treated with endovascular embolization. In this report, we review all previous cases of ruptured LSA aneurysms related to MMD. CONCLUSION: LSA aneurysm rupture should be considered in the setting of hemorrhagic MMD, especially in combination with basal ganglia hematoma. Proximal and distal LSA aneurysms appear to have different types of hemorrhage. This case highlights that management of such aneurysms should be individualized based on the balance of benefits and risks.