Computed tomography angiography evidence of distal lenticulostriate artery aneurysm

A 48yearold male with a history of hypertension presented to the emergency department with acute onset leftsided weakness, dysarthria, and blood pressure of 196/113 mm Hg. Head computed tomography (CT) revealed a right basal ganglia and subarachnoid hemorrhage. (Figure 1A) Head CT angiogram showed a 2.9 mm aneurysm in the medial distal lenticulostriate artery (LSA) within the area of hematoma suggestive of aneurysm rupture. (Figure 1B– D). Aneurysms of LSA are a rare finding with an average diameter of 3.88 mm (ranging from 1– 19 mm) and are usually missed by CT angiogram.1,2 These aneurysms can be located either proximally near