scholarly journals Isolated Posterior Spinal Artery Aneurysm Causing Subarachnoid Hemorrhage

2016 ◽  
Vol 30 (1) ◽  
pp. 101-103
Author(s):  
Toshiro Katsuta ◽  
Yoshinobu Horio ◽  
Kazuhiro Samura ◽  
Naoki Wakuta ◽  
Kenji Fukuda ◽  
...  
Neurosurgery ◽  
2012 ◽  
Vol 71 (3) ◽  
pp. E749-E756 ◽  
Author(s):  
Hyun Jeong Kim ◽  
In Sup Choi

Abstract BACKGROUND AND IMPORTANCE: Because of their rarity, the pathogenesis and clinical features of isolated spinal artery aneurysms are still unclear, and their diagnoses and treatments are challenging. We report a case of an isolated posterior spinal artery aneurysm and review previous reports thoroughly to identify the general features of isolated spinal aneurysms. CLINICAL PRESENTATION: A 52-year-old man presented with abdominal pain followed by back pain and radiculopathy from subarachnoid hemorrhage in the spinal canal. The spinal angiogram demonstrated the presence of a dissecting aneurysm of the posterior spinal artery. He was treated by endovascular occlusion of the origin of the radiculopial artery and recovered completely. CONCLUSION: Isolated spinal artery aneurysms are very rare lesions; however, they should be considered in patients with intracranial or spinal subarachnoid hemorrhage without evidence of arteriovenous malformations. Spinal aneurysms have different etiologies compared with intracranial aneurysms. Cervical aneurysms have worse outcomes than thoracolumbar aneurysms. The etiology and location of the lesion and distal flow to the lesion should be taken into consideration when planning the treatment.


2015 ◽  
Vol 55 (12) ◽  
pp. 915-919 ◽  
Author(s):  
Yoshinobu HORIO ◽  
Toshiro KATSUTA ◽  
Kazuhiro SAMURA ◽  
Naoki WAKUTA ◽  
Kenji FUKUDA ◽  
...  

2020 ◽  
Vol 134 ◽  
pp. 544-547 ◽  
Author(s):  
Kento Takebayashi ◽  
Tomomi Ishikawa ◽  
Masato Murakami ◽  
Takayuki Funatsu ◽  
Tasuya Ishikawa ◽  
...  

2021 ◽  
Vol 1 (22) ◽  
Author(s):  
Armaan K. Malhotra ◽  
Jerry C. Ku ◽  
Vitor M. Pereira ◽  
Ivan Radovanovic

BACKGROUND Angiogram-negative nontraumatic subarachnoid hemorrhage (SAH) can be diagnostically challenging, and a broad differential diagnosis must be considered. Particular attention to initial radiographic hemorrhage distribution is essential to guide adjunctive investigations. Posterior spinal artery aneurysms are rare clinical entities with few reported cases in the literature. An understanding of isolated spinal artery aneurysm natural history, diagnosis, and management is evolving as more cases are identified. OBSERVATIONS Isolated thoracic posterior spinal artery aneurysm can be the culprit lesion in perimesencephalic distribution SAH. Embolization resulted in complete aneurysm occlusion and did not result in periprocedural morbidity. At the 1-year follow-up, the patient was neurologically intact with no recurrence on magnetic resonance angiography. LESSONS This case report highlighted the presentation, diagnostic workup, clinical decision-making, and endovascular intervention for a woman who presented with SAH secondary to posterior spinal artery aneurysm. After initially negative results on vascular imaging, dedicated spinal vascular imaging revealed the location of the aneurysm. Multiple treatment modalities exist for isolated spinal artery aneurysms and must be selected on the basis of patient- and lesion-specific characteristics.


2010 ◽  
Vol 16 (2) ◽  
pp. 183-190 ◽  
Author(s):  
S. Geibprasert ◽  
T. Krings ◽  
J. Apitzsch ◽  
M.H.T. Reinges ◽  
K.W. Nolte ◽  
...  

Isolated posterior spinal artery aneurysms are rare vascular lesions. We describe the case of a 43-year-old man presenting with spinal subarachnoid hemorrhage after a minor trauma who was found to have a dissecting aneurysm of a posterior spinal artery originating from the right T4 level. Endovascular treatment was not contemplated because of the small size of the feeding artery, whereas surgical resection was deemed more appropriate because of the posterolateral perimedullary location that was well appreciated on CT angiography. After surgical resection of the aneurysm the patient had a complete neurological recovery. In comparison to anterior spinal artery aneurysms whose pathogenesis is diverse, posterior spinal aneurysms are most often secondary to a dissection and represent false or spurious aneurysms. Although the definite diagnosis still requires spinal angiography, MRI and CT may better delineate the relationship of the aneurysm to the spinal cord in order to determine the best treatment method. Prompt treatment is recommended as they have high rebleeding and mortality rates.


2018 ◽  
Vol 11 (1) ◽  
pp. e014511 ◽  
Author(s):  
Azeem A Rehman ◽  
Ryan C Turner ◽  
Stephanie Wright ◽  
SoHyun Boo ◽  
Ansaar T Rai

A middle-aged patient presented with posterior circulation symptoms attributable to a large eccentric basilar trunk aneurysm. The planned treatment was flow diversion with loose coil packing which was successfully performed using a Pipeline Flex device deployed from the basilar to the left posterior cerebral artery. The complete procedure including live biplane fluoroscopy was digitally recorded. The patient had symptomatic improvement postoperatively and was discharged on day 1. The patient suffered a cardiac arrest on postoperative day 3 secondary to massive intraventricular and subarachnoid hemorrhage. An aneurysm rupture was suspected; however, postmortem examination showed an intact aneurysm sac. The hemorrhage was attributed to a small focal rent in the distal basilar artery next to an atheromatous plaque. The Pipeline device was visible through the rent. This is an autopsy report documenting an injury to the parent artery and not the aneurysm as a source of fatal delayed subarachnoid hemorrhage following flow diversion.


2018 ◽  
Vol 37 (03) ◽  
pp. 263-266
Author(s):  
Lucas Meguins ◽  
Linoel Valsechi ◽  
Ronaldo Fernandes ◽  
Dionei Morais ◽  
Antonio Spotti

Introduction Pericallosal artery (PA) aneurysms represent 2 to 9% of all intracranial aneurysms, and their management remains difficult. Objective The aim of the present study is to describe the case of an adult woman with subarachnoid hemorrhage and bilateral PA aneurysm in mirror position. Case Report A 46-year-old woman was referred to our institution 20 days after a sudden severe headache. She informed that she was treating her arterial hypertension irregularly, and consumed ∼ 20 cigarettes/day. The patient was neurologically intact at admission. A non-contrast computed tomography (CT) on the first day of the onset of the symptoms revealed hydrocephaly and subarachnoid hemorrhage (Fisher III). An angio-CT/digital subtraction arteriography showed bilateral PA aneurysms in mirror position. The patient was successfully treated with surgery via the right interhemispheric approach (because the surgeon is right-handed); the surgeon performed the proximal control with temporary clipping, and introduced an external ventricular drain at the end of the surgery. The patient was discharged on the fourth postoperative day without any additional neurological deficits or ventricular shunts. Conclusion Ruptured PA aneurysm is a surgically challenging aneurysm due to the many anatomical nuances and risk of rebleeding. However, the operative management of ruptured bilateral PA aneurysms is feasible and effective.


2010 ◽  
Vol 16 (3) ◽  
pp. 259-263 ◽  
Author(s):  
P.S. Kochar ◽  
W.F. Morrish ◽  
M.E. Hudon ◽  
J.H. Wong ◽  
M. Goyal

Aneurysms of the lenticulostriatal perforating arteries are rare and either involve the middle cerebral artery-perforator junction or are located distally in basal ganglia. We describe a rare ruptured fusiform lenticulostriatal perforating artery aneurysm arising from a proximal M2 MCA branch, discerned on superselective microcatheter angiography, presenting solely with subarachnoid hemorrhage (SAH). A 50-year-old previously healthy man presented with diffuse SAH and negative CT angiogram. Cerebral angiogram demonstrated a 2 mm fusiform aneurysm presumably arising from the right lateral lenticulostriate perforator but the exact origin of the perforator was unclear. Superselective angiography was required to precisely delineate the aneurysm and its vessel of origin and directly influenced treatment planning (surgical trapping). Superselective microcatheter angiography provides both an option for endovascular therapy as well as more accurate delineation for surgical planning for these rare aneurysms.


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