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Charcot-Bouchard aneurysm

Last revised by Rohit Sharma on 12 Feb 2024

Charcot-Bouchard aneurysms are thought to be minute aneurysms which develop along perforating arteries as a result of chronic hypertension, most commonly in the basal ganglia and other areas such as the thalamus, pons and cerebellum. They are believed to be the source of hypertensive hemorrhages

Pathology

Charcot-Bouchard aneurysms are thought to be the result of lipohyalinosis of small penetrating vessels (diameter <300 micrometers) secondary to chronic poorly controlled hypertension 1-3. This results in vessels with a defect in the muscular coat and only a thin intimal layer with some surrounding gliosis 3. Thus, Charcot-Bouchard aneurysms are prone to rupture, with the inability to control bleeding by vasomotor spasm 3.

They have, however, proven difficult to fully characterize and some authors have even cast doubt upon their very existence suggesting, instead, that they represent artifacts due to vessel tortuosity 6,7. Still others have suggested that they represent pseudoaneurysms which sometimes have been referred to as hemostatic globes, fibrin globes or bleeding globes 8

Not only is there controversy over the nature and very existence of Charcot-Bouchard aneurysms but their incidence and whether or not they actually are the cause of hemorrhage is also disputed 8

In any event, they should not be confused with saccular aneurysms found in larger intracranial vessels in the subarachnoid space 1,4.

History and etymology

These small parenchymal microaneurysms were first described in 1868 by Jean-Martin Charcot (1825-1893) and Charles-Joseph Bouchard (1837-1915), both French pathologists 5

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