J Neurol Surg A Cent Eur Neurosurg 2013; 74(06): 410-414
DOI: 10.1055/s-0032-1320025
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Spinal Subarachnoid Hemorrhage Secondary to Rupture of an Isolated Radicular Artery Aneurysm

Paul Marovic
1   Department of Neurosurgery, Southern Health, Melbourne, Victoria, Australia
,
Nova Thani
1   Department of Neurosurgery, Southern Health, Melbourne, Victoria, Australia
,
Steven Lu
1   Department of Neurosurgery, Southern Health, Melbourne, Victoria, Australia
,
Arul Bala
1   Department of Neurosurgery, Southern Health, Melbourne, Victoria, Australia
› Author Affiliations
Further Information

Publication History

28 November 2011

29 December 2011

Publication Date:
11 December 2012 (online)

Abstract

Aneurysmal subarachnoid hemorrhage (aSAH) of spinal origin is an uncommon entity and comprises less than 1% of all aSAH. The paucity of clinical cases creates challenges to its diagnosis and management. We present the case of a 58-year-old male, who presented with a spinal subarachnoid hemorrhage secondary to a de novo spinal radicular artery aneurysm. Spinal subarachnoid hemorrhages typically occur secondary to arteriovenous malformations or arterial wall weakness seen in collagen vascular disease. Fewer than 20 cases of isolated spinal arterial aneurysms have been published. SAHs of spinal origin are exceedingly rare and thus a high index of suspicion is required for an accurate and timely diagnosis.

 
  • References

  • 1 Koçak A, Ateş O, Cayli SR, Saraç K. Isolated posterior spinal artery aneurysm. Br J Neurosurg 2006; 20 (4) 241-244
  • 2 Berlis A, Scheufler KM, Schmahl C, Rauer S, Götz F, Schumacher M. Solitary spinal artery aneurysms as a rare source of spinal subarachnoid hemorrhage: potential etiology and treatment strategy. AJNR Am J Neuroradiol 2005; 26 (2) 405-410
  • 3 Chen CC, Bellon RJ, Ogilvy CS, Putman CM. Aneurysms of the lateral spinal artery: report of two cases. Neurosurgery 2001; 48 (4) 949-953 , discussion 953–954
  • 4 Ohmori Y, Hamada J, Morioka M, Yoshida A. Spinal aneurysm arising from the feeding pedicle of a thoracic perimedullary arteriovenous fistula: case report. Surg Neurol 2005; 64 (5) 468-470
  • 5 Rengachary SS, Duke DA, Tsai FY, Kragel PJ. Spinal arterial aneurysm: case report. Neurosurgery 1993; 33 (1) 125-129 , discussion 129–130
  • 6 Saunders FW, Birchard D, Willmer J. Spinal artery aneurysm. Surg Neurol 1987; 27 (3) 269-272
  • 7 Cavuşoğlu H, Ozdilmaç A, Sahin Y, Aydin Y. Isolated posterior spinal artery aneurysm causing intracranial acute subarachnoidal hemorrhage. Acta Neurochir (Wien) 2010; 152 (4) 721-724
  • 8 Pollock JM, Powers AK, Stevens EA, Sanghvi AN, Wilson JA, Morris PP. Ruptured anterior spinal artery aneurysm: a case report. J Neuroimaging 2009; 19 (3) 277-279
  • 9 Henson RA, Croft PB. Spontaneous spinal subarachnoid haemorrhage. Q J Med 1956; 25 (97) 53-66
  • 10 Kinal ME, Sejanovich C. Spinal cord compression by an intramedullary aneurysm; case report and review of the literature. J Neurosurg 1957; 14 (5) 561-565
  • 11 Hopkins CA, Wilkie FL, Voris DC. Extramedullary aneurysm of the spinal cord. Case report. J Neurosurg 1966; 24 (6) 1021-1023
  • 12 Leech PJ, Stokes BA, ApSimon T, Harper C. Unruptured aneurysm of the anterior spinal artery presenting as paraparesis. Case report. J Neurosurg 1976; 45 (3) 331-333
  • 13 Thomson RL. Aneurysm in the cervical spinal canal. Med J Aust 1980; 1 (5) 220-222
  • 14 Vincent FM. Anterior spinal artery aneurysm presenting as a subarachnoid hemorrhage. Stroke 1981; 12 (2) 230-232
  • 15 Moore DW, Hunt WE, Zimmerman JE. Ruptured anterior spinal artery aneurysm: repair via a posterior approach. Neurosurgery 1982; 10 (5) 626-630
  • 16 Smith BS, Penka CF, Erickson LS, Matsuo F. Subarachnoid hemorrhage due to anterior spinal artery aneurysm. Neurosurgery 1986; 18 (2) 217-219
  • 17 Takahashi K, Kayama T, Sakurai Y, Ogawa A. [A case of aneurysm at the junction of the vertebral artery and a spinal arterial branch]. No Shinkei Geka 1986; 14 (8) 1025-1029
  • 18 Goto Y, Kamijyo Y, Yonekawa Y, Kikuchi H. Ruptured aneurysm of the posterior spinal artery of the upper cervical spinal cord: case report. Neurosurgery 1988; 22 (3) 558-560
  • 19 el Mahdi MA, Rudwan MA, Khaffaji SM, Jadallah FA. A giant spinal aneurysm with cord and root compression. J Neurol Neurosurg Psychiatry 1989; 52 (4) 532-535
  • 20 Handa T, Suzuki Y, Saito K, Sugita K, Patel SJ. Isolated intramedullary spinal artery aneurysm presenting with quadriplegia. Case report. J Neurosurg 1992; 77 (1) 148-150