Incidence of aneurysm of the anterior spinal artery is known to be very low and the standard treatment strategy has not yet been established. The author experienced a case of subarachnoid hemorrhage (SAH) caused by the rupture of an aneurysm in the branch of the cervical anterior spinal artery, which was managed conservatively. The patient had end-stage common bile duct cancer and survived for 103 days after onset of the SAH without a re-rupture of the aneurysm.

Spontaneous spinal subdural hematoma (SDH) is very rare. Furthermore, intracranial vasospasm (ICVS) associated with spinal hemorrhage has been very rarely reported. We present an ICVS case without intracranial hemorrhage following SDH. A 41-year-old woman was admitted to our hospital with a complaint of severe headache. Multiple intracranial vasospasms were noted on a brain CT angiogram and transfemoral cerebral angiography. However, intracranial hemorrhage was not revealed by brain MRI or CT. On day 3 after admission, weakness of both legs and urinary incontinence developed. Spine MRI showed C7~T6 spinal cord compression due to hyperacute stage of SDH. After hematoma evacuation, her symptoms gradually improved. We suggest that spinal cord evaluation should be considered in patients with headache who have ICVS, although intracranial hemorrhage would not be visible in brain images.

These results strongly suggest that Ca(2+)-activated potassium channels and L type Ca(2+) channels may be involved in papaverine-induced vascular relaxation in rat basilar artery.

There has been a controversy over data of thrombolytic and endovascular surgical treatment about cerebral infarction secondary to infective endocarditis. We report a woman who received early mechanical embolectomy as a treatment of acute stroke with infective endocarditis. A 35-yr-old woman was hospitalized due to right hemiparesis. Brain image showed cerebral infarction at the middle cerebral artery and echocardiography demonstrated vegetation at the mitral valve. She was successfully treated with embolectomy and parenteral antibiotics without any neurologic sequelae. This report shows that the early retrieve of septic cerebral emboli can be a helpful treatment of acute stroke associated with endocarditis.

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