Aneurysms of the Lenticulostriate Artery: A Systematic Review.

BACKGROUND: Lenticulostriate artery aneurysms (LSA) are a rare vascular aberration. Despite the potentially catastrophic sequelae of the rupture of an LSA aneurysm, the optimal management strategy remains to be determined. The aim of this review is to provide an overview of the clinical presentation and treatment strategies of LSA aneurysms. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a literature search was conducted in the PubMed, Cochrane, EBSCOhost, Scopus, Web of Science and ProQuest search engines to identify published literature regarding LSA aneurysms up until July 1, 2020. A descriptive analysis was performed. RESULTS: 71 studies were included with a total of 112 cases of LSA aneurysms. Patient age ranged from 2 months to 83 years, with a median of 44.5 years. Both males and females were similarly affected (49% and 51%, respectively). The most common presentation was aneurysmal rupture (78%) and headache was the most frequently reported symptom (36%). Overall, 48% of patients underwent surgical treatment, 30% conservative management, 21% endovascular treatment, and 1% radiosurgery. A total of 4 cases resulted in patient death, all of which presented with aneurysmal rupture. CONCLUSION: Published cases of LSA aneurysms along with their clinical presentation, management and outcomes have been synthetized for physicians who are confronted with this diagnosis. Future reports adhering to currently available classification systems and including as much detail as possible should be encouraged to fully elucidate the optimal management available for these patients.