Lacunar stroke vs Charcot Bouchard Aneurysm Rupture - USMLE Forums
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Old 10-30-2012
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Neuro Lacunar stroke vs Charcot Bouchard Aneurysm Rupture

hi mates

here is another topic(lacunar stroke vs charcot bouchard aneurysm rupture) of my confusion...firstly i thought these both are similar involving lenticulostriate arteries..............
after many working days i gotta know a clear idea of them..now i'm able to differentiate them by case history.....but i have problem in finding both in CT's and i think this 2 are high yield for CT questions(in uworld around 3-4 q's are based on them i guess).......
so can anyone find me some clues in finding them in CT's .........

thanks
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Old 10-30-2012
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Lacunar strokes are ishchaemic strokes due to atheroma in small vessels.
charchod bouchard aneurysms lead to intracerebral haemorrhage.

u can easily differentiate bw ishemic and haemorrhagic stroke on CT
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Old 10-30-2012
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Quote:
Originally Posted by Timmi View Post
Lacunar strokes are ishchaemic strokes due to atheroma in small vessels.
charchod bouchard aneurysms lead to intracerebral haemorrhage.

u can easily differentiate bw ishemic and haemorrhagic stroke on CT
thanks....i know their difference and i can differentiate all the other causes of hemorrhagic and ischemic strokes causes except these 2(as both in basal ganglia region)

show some light on them for me(how would you differentiate them in CT..?---i mean your ways of differentiating..?)

thanks
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Old 10-30-2012
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Quote:
Originally Posted by venky2600 View Post
thanks....i know their difference and i can differentiate all the other causes of hemorrhagic and ischemic strokes causes except these 2(as both in basal ganglia region)

show some light on them for me(how would you differentiate them in CT..?---i mean your ways of differentiating..?)

thanks
Haemorrhagic stroke post aneurysm is hyperintense(more white relative adjacent brain paranchyma) in basal ganglia are on CT and while Lacunar stroke is pale area (dark as compared to brain parenchyma) in basal ganglia reigon, although MRI helps more as compared to CT in diagnosing Lacunar stroke due to their small size.
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Charcot Bouchard MICROaneurysm
1.involves the lenticulostriate vessels
2.cause Intracerebral hemorrage.
CT/MRI shows lesion at the basal ganglia mostly

Berry aneurysm
1.involves mostly Anterior Communicating artery
2.cause Subarachnoid Hemorrhage
CT/MRI shows diffuse hypodense areas in subarachnoid space
Buzz wordxt often c/o worst headache of my life
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Old 06-09-2015
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Lacunar Stroke

Two more points
1) invole hyaline ateriolosclerosis
2) small lake like infarcts(Buzz word)
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