Charcot Bouchard Microaneurysm

Charcot–Bouchard aneurysms (also known as miliary aneurysms or microaneurysms) are aneurysms of the brain vasculature which occur in small blood vessels (less than 300 micrometre diameter). 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 cerebral hemorrhage.

Signs and symptoms

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.

Pathophysiology

Charcot–Bouchard aneurysms are aneurysms in the small penetrating blood vessels of the brain. They are associated with hypertension. The common artery involved is the lenticulostriate branch of the middle cerebral artery. Common locations of hypertensive hemorrhages include the putamen, caudate, thalamus, pons, and cerebellum


Important Points for USMLE 
Lacunar strokes are ischaemic strokes due to atheroma in small vessels while charchod bouchard aneurysms lead to intracerebral haemorrhage.

	Charcot Bouchard Aneurysm	Saccular Anneursysm
Assosciated Conditions	Hypertension	ADPKD, Ehlers-Danlos Syndrome, Hypertension
Location	Basal Ganglia Cerrebellum Thalamus Pons	Circle of willis
Size	< 1 mm	Variable, 2-25mm
Result of Rupture	Intracerebral hemorrhage	Subarachnoid Hemorrhage
Symptoms of Rupture	Progressive Neurologic Defects Headache may follow	Sudden severe headache Focal neurologic defects uncommon