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Abstract
Behçet's disease (BD) is characterized by recurrent oro-genital ulcers, skin lesions, and intraocular inflammation, but can also affect various internal organs. Vascular BD usually presents with luminal stenosis, thrombosis, or aneurysm formation in aorta and peripheral arteries. However, intracranial artery involvement has been uncommonly reported in patients with BD and BD cases with lenticulostriate artery aneurysm have been rarely described in the English-language literature. We hereby reported the first case of a Korean BD patient presenting with a ruptured lenticulostriate artery aneurysm, who received medical treatment, and reviewed the literature on reported cases of BD with intracranial aneurysms.
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Figure 1.
Colonoscopic findings and brain magnetic resonance imaging (MRI) scan images. Colonoscopy showed a large and deep ulcer with a discrete margin in the ileocecal area (A). Acute intracerebral hemorrhage (arrow heads) was visualized in the right temporal pole on axial T1-weighted (B) and T2-weighted (C) scans. An acute infarct in the right basal ganglia (arrows) was clearly identified on axial T2-weighted (D), apparent diffusion coefficient (ADC) (E), and diffusion weighted imaging (DWI) (F) MRI scans.
Figure 2.
Cerebral angiography. Time-of-flight (TOF) magnetic resonance angiography (MRA) using sensitivity encoding (SEN-SE) showed intracerebral hemorrhage adjacent to the M1 segment of the middle cerebral artery (arrow) (A), but MRA did not reveal any abnormality in the M1 segment (B). The initial trans-femoral cerebral angiography (TFCA) prior to glucocorticoid therapy showed a fusiform aneurysm of the right lenticulostriate artery (LSA) and irregu-larity of the vascular wall (C); the inset shows the magnified image of LSA aneurysm (asterisk). After a month of high-dose glucocorticoid treatment, the LSA aneurysm was disappeared on follow-up TFCA (D). ICA: internal carotid artery.
Table 1.
Comparison ofclinical features in Korean Behçet's disease patients with intracranial aneurysm
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