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Pathological changes in the lenticulostriate artery indicate the mechanisms leading to intracranial hemorrhage in Moyamoya disease: a case report

  • Atsushi Hashio,
  • Eika Hamano,
  • Saya Ozaki,
  • Kinta Hatyakeyama,
  • Yoshihiko Ikeda,
  • Akihiro Niwa,
  • Naoto Yamada,
  • Taichi Ikedo,
  • Kiyofumi Yamada,
  • Hirotoshi Imamura,
  • Hisae Mori,
  • Koji Iihara,
  • Hiroharu Kataoka

摘要

This case report details the pathological findings of a vessel wall identified as the bleeding point for intracranial hemorrhage associated with Moyamoya disease. A 29-year-old woman experienced intracranial hemorrhage unrelated to hyperperfusion following superficial temporal artery-middle cerebral artery bypass surgery. A pseudoaneurysm on the lenticulostriate artery (LSA) was identified as the causative vessel and subsequently excised. Examination of the excised pseudoaneurysm revealed a fragment of the LSA, with a disrupted internal elastic lamina and media degeneration. These pathological findings in a perforating artery, akin to the circle of Willis, provide insights into the underlying mechanisms of hemorrhage in Moyamoya disease.