Management Considerations in Ruptured Isolated Radiculopial Artery Aneurysms

Little is known on the natural history of ruptured isolated aneurysms of the posterior spinal artery (PSA). To date, only a few of such cases have been described in the literature. This paper aims to assess the most appropriate management strategy, based on the available literature and two new cases. In one of these, treatment was postponed until day 33, when angiography showed slight growth of the aneurysm. In the other, conservative treatment, requested by the patient, was successful. From these data, we conclude that treatment strategies for ruptured PSA aneurysms may vary. Aside from the recommendation by others to perform prompt surgical treatment, we suggest an alternative clinical paradigm allowing for the evaluation of the early clinical course. This may preclude the unnecessary treatment of spontaneously regressing lesions and still allows for appropriate treatment for persistent lesions.

[1]  T. Krings,et al.  Subarachnoid Hemorrhage following Posterior Spinal Artery Aneurysm , 2010, Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences.

[2]  T. Maehara,et al.  Subarachnoid hemorrhage caused by a ruptured anterior spinal artery aneurysm. , 2010, Neurologia medico-chirurgica.

[3]  E. A. Stevens,et al.  Ruptured Anterior Spinal Artery Aneurysm: A Case Report , 2009, Journal of neuroimaging : official journal of the American Society of Neuroimaging.

[4]  A. Weill,et al.  Selective treatment of an anterior spinal artery aneurysm with endosaccular coil therapy. Case report. , 2007, Journal of neurosurgery. Spine.

[5]  R. Hevner,et al.  Dissecting aneurysm of the thoracic posterior spinal artery. Case illustration. , 2006, Journal of neurosurgery. Spine.

[6]  K. Saraç,et al.  Isolated posterior spinal artery aneurysm , 2006, British journal of neurosurgery.

[7]  R. Spetzler,et al.  Spontaneous Spinal Subarachnoid Hemorrhage Secondary to Spinal Aneurysms: Diagnosis and Treatment Paradigm , 2005, Neurosurgery.

[8]  R. Spetzler,et al.  Subarachnoid hemorrhage due to isolated spinal artery aneurysm in four patients. , 2005, AJNR. American journal of neuroradiology.

[9]  F. Götz,et al.  Solitary spinal artery aneurysms as a rare source of spinal subarachnoid hemorrhage: potential etiology and treatment strategy. , 2005, AJNR. American journal of neuroradiology.

[10]  S. Pongpech,et al.  Ruptured Anterior Spinal Artery Aneurysm Associated with Coarctation of Aorta , 2002, Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences.

[11]  N. Futran,et al.  Destructive tophaceous calcium hydroxyapatite tumor of the infratemporal fossa. Case report and review of the literature. , 1999, Journal of neurosurgery.

[12]  D. Roy,et al.  Transarterial embolization of aneurysms associated with spinal cord arteriovenous malformations. Report of four cases. , 1999, Journal of neurosurgery.

[13]  R. Spetzler,et al.  Aneurysm of the intradural artery of Adamkiewicz treated with muslin wrapping: technical case report. , 1997, Neurosurgery.

[14]  P. Kragel,et al.  Spinal arterial aneurysm: case report. , 1993, Neurosurgery.

[15]  J. Bederson,et al.  Treatment of fusiform intracranial aneurysms by circumferential wrapping with clip reinforcement. Technical note. , 1992, Journal of neurosurgery.

[16]  K. Sugita,et al.  Isolated intramedullary spinal artery aneurysm presenting with quadriplegia. Case report. , 1992, Journal of neurosurgery.

[17]  Y. Yonekawa,et al.  Ruptured aneurysm of the posterior spinal artery of the upper cervical spinal cord: case report. , 1988, Neurosurgery.

[18]  R. Djindjian.  Angiography of the spinal cord. , 1974, Acta neurologica latinoamericana.

[19]  R. A. Henson,et al.  Spontaneous spinal subarachnoid haemorrhage. Report of 3 cases. , 1966, Journal of neurosurgery.

[20]  R. A. Henson,et al.  SPONTANEOUS SPINAL SUBARACHNOID HAEMORRHAGE1 , 1956 .