Introduction: Spontaneous spinal subarachnoid hemorrhage (SAH) occurs in less than 1% of all cases of SAH, and idiopathic spontaneous spinal SAH is even more rare. Methods: A 48-year-old man presented with a sudden onset of low back pain without any neurological deficit. There was no history of either trauma or the use of anticoagulants. Magnetic resonance (MR) imaging of the lumbar spine revealed an intradural linear mass from T12 to L3, ventral to the conus medullais and cauda equina. The mass was of iso-signal intensity in T2-weighted images, of high signal intensity in T1-weighted images, and was not enhanced following injection of gadolium. Lumbar tapping revealed bloody cerebrospinal fluid, confirming SAH. At 1 month after the onset of symptom, his pain subsided spontaneously and no vascular abnormality was found by spinal angiography. Follow-up MR imaging confirmed the complete resolution of the SAH. Conclusion: We report a case of idiopathic spontaneous spinal SAH at the lumbar level in a 48-year-old man.

There are a number of reports on cerebral aneurysmal ruptures during pregnancy. Although the cerebral aneurysmal rupture is quite rare during pregnancy, it leads to a high maternal mortality; which gives rise to a clinical significance. We have encountered a number of multiple cerebral aneurysms during pregnancy, and the ruptured cases were successfully treated with the coiling procedures. The coiling is found to be a good treatment method for ruptured aneurysms during pregnancy. The cerebral angiogram is the gold standard diagnostic method for detecting cerebral aneurysms. However, 1.8–20% of the cases are reported to be false negative in initial angiography, and only up to 20% can be diagnosed even with the additional angiographies. A special attention for a hidden aneurysm should also be required while managing the patients.

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