Charcot-Bouchard aneurysm
Encyclopedia
Charcot-Bouchard aneurysms (also known as miliary aneurysms or microaneurysms) are aneurysms of the brain vasculature which occur in small blood vessel
s (less than 300 micrometre
diameter). They should not be confused with saccular aneurysms (a.k.a. berry aneurysms), which occur in larger-sized blood vessels. Charcot-Bouchard aneurysms are most often located in the lenticulostriate
vessels of the basal ganglia
and are associated with chronic
hypertension
. Charcot-Bouchard aneurysms are a common cause of stroke
.
s of the brainstem and midbrain. They are associated with hypertension
. The common artery involved is Lenticulostriate branch of Middle cerebral artery
. Common locations of hypertensive hemorrhages include the putamen
, caudate
, thalamus
, pons
, and cerebellum
.
As with any aneurysm, once formed they have a tendency to expand and eventually rupture, in keeping with the Law of Laplace. If a Charcot-Bouchard aneurysm ruptures, it will lead to an intracerebral hemorrhage, which can cause hemorrhagic stroke, typically experienced as a sudden focal paralysis or loss of sensation. In contrast, if a saccular aneurysm ruptures, it will lead to a subarachnoid hemorrhage
, typically experienced as an extremely severe headache leading to loss of consciousness. Both situations are medical emergencies, but a subarachnoid hemorrhage is more dangerous, with mortality between 25 and 50%.
and Charles-Joseph Bouchard
. It was Bouchard who discovered these aneurysms during his doctoral research under Charcot.
Blood vessel
The blood vessels are the part of the circulatory system that transports blood throughout the body. There are three major types of blood vessels: the arteries, which carry the blood away from the heart; the capillaries, which enable the actual exchange of water and chemicals between the blood and...
s (less than 300 micrometre
Micrometre
A micrometer , is by definition 1×10-6 of a meter .In plain English, it means one-millionth of a meter . Its unit symbol in the International System of Units is μm...
diameter). They should not be confused with saccular aneurysms (a.k.a. berry aneurysms), which occur in larger-sized blood vessels. Charcot-Bouchard aneurysms are most often located in the lenticulostriate
Anterolateral central arteries
The anterolateral central arteries, antero-lateral ganglionic branches, or lenticulostriate arteries, are a group of small arteries which arise at the commencement of the middle cerebral artery, are arranged in two sets:...
vessels of the basal ganglia
Basal ganglia
The basal ganglia are a group of nuclei of varied origin in the brains of vertebrates that act as a cohesive functional unit. They are situated at the base of the forebrain and are strongly connected with the cerebral cortex, thalamus and other brain areas...
and are associated with chronic
Chronic (medicine)
A chronic disease is a disease or other human health condition that is persistent or long-lasting in nature. The term chronic is usually applied when the course of the disease lasts for more than three months. Common chronic diseases include asthma, cancer, diabetes and HIV/AIDS.In medicine, the...
hypertension
Hypertension
Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...
. Charcot-Bouchard aneurysms are a common cause of stroke
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
.
Presentation
Charcot-Bouchard aneurysms are aneurysms in the small penetrating blood vesselBlood vessel
The blood vessels are the part of the circulatory system that transports blood throughout the body. There are three major types of blood vessels: the arteries, which carry the blood away from the heart; the capillaries, which enable the actual exchange of water and chemicals between the blood and...
s of the brainstem and midbrain. They are associated with hypertension
Hypertension
Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...
. The common artery involved is Lenticulostriate branch of Middle cerebral artery
Middle cerebral artery
-External links:*...
. Common locations of hypertensive hemorrhages include the putamen
Putamen
The putamen is a round structure located at the base of the forebrain . The putamen and caudate nucleus together form the dorsal striatum. It is also one of the structures that comprises the basal ganglia. Through various pathways, the putamen is connected to the substantia nigra and globus pallidus...
, caudate
Caudate
Caudate can refer to:* Caudate nucleus* Caudate lobe of liver* Cauda equina* Members of the Caudata order....
, thalamus
Thalamus
The thalamus is a midline paired symmetrical structure within the brains of vertebrates, including humans. It is situated between the cerebral cortex and midbrain, both in terms of location and neurological connections...
, pons
Pons
The pons is a structure located on the brain stem, named after the Latin word for "bridge" or the 16th-century Italian anatomist and surgeon Costanzo Varolio . It is superior to the medulla oblongata, inferior to the midbrain, and ventral to the cerebellum. In humans and other bipeds this means it...
, and cerebellum
Cerebellum
The cerebellum is a region of the brain that plays an important role in motor control. It may also be involved in some cognitive functions such as attention and language, and in regulating fear and pleasure responses, but its movement-related functions are the most solidly established...
.
As with any aneurysm, once formed they have a tendency to expand and eventually rupture, in keeping with the Law of Laplace. If a Charcot-Bouchard aneurysm ruptures, it will lead to an intracerebral hemorrhage, which can cause hemorrhagic stroke, typically experienced as a sudden focal paralysis or loss of sensation. In contrast, if a saccular aneurysm ruptures, it will lead to a subarachnoid hemorrhage
Subarachnoid hemorrhage
A subarachnoid hemorrhage , or subarachnoid haemorrhage in British English, is bleeding into the subarachnoid space—the area between the arachnoid membrane and the pia mater surrounding the brain...
, typically experienced as an extremely severe headache leading to loss of consciousness. Both situations are medical emergencies, but a subarachnoid hemorrhage is more dangerous, with mortality between 25 and 50%.
Eponym
Charcot-Bouchard aneurysms are named for the French physicians Jean-Martin CharcotJean-Martin Charcot
Jean-Martin Charcot was a French neurologist and professor of anatomical pathology. He is known as "the founder of modern neurology" and is "associated with at least 15 medical eponyms", including Charcot-Marie-Tooth disease and amyotrophic lateral sclerosis...
and Charles-Joseph Bouchard
Charles-Joseph Bouchard
Charles-Joseph Bouchard was a French pathologist born in Montier-en-Der, a commune the department of Haute-Marne. He studied medicine in Lyon and Paris, where he obtained his doctorate in 1866. In 1874 he became a physician at Bicêtre Hospital, and in 1879 was appointed chair of general pathology...
. It was Bouchard who discovered these aneurysms during his doctoral research under Charcot.
Other conditions
Other causes of intracranial hemorrhage include:- Saccular aneurysm (aka berry aneurysm)
- Arteriovenous malformationsArteriovenous malformationArteriovenous malformation or AVM is an abnormal connection between veins and arteries, usually congenital. This pathology is widely known because of its occurrence in the central nervous system, but can appear in any location. An arteriovenous malformation is a vascular anomaly. It is a...