Dorsal subdural hemorrhage from ruptured thoracic radicular artery pseudoaneurysm. case report and surgical video

Minardi, Massimiliano; Vercelli, Giovanni; Mammi, Marco; Fiumefreddo, Alessandro; Garbossa, Diego

doi:10.1016/j.clineuro.2021.106505

Cited by 2 publications

(3 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the last decades our knowledge of these pathologies has increased and, as a result, different classification schemes have been proposed with the aim of better identifying the natural history, the clinical presentation, and the ideal treatment (3,4). Spinal arteriovenous fistulas are currently believed to be a treatable cause of myelopathy (12,13). There is therefore an indication to treat all spinal arteriovenous fistulas that are diagnosed.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, clinical deterioration can also occur rapidly, so it is advisable to treat quickly once the diagnosis has been made. These types of malformations rarely could be associated with subarachnoid or subdural hemorrhage inside the spinal canal going into differential diagnosis with other vascular malformation ( 14 , 15 ). Treatment consists in interrupting the shunt between the root artery and medullary vein whether it is in the epidural space or in the context of the dura mater ( Figure 2 ).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Spinal dural and epidural arteriovenous fistula: Recurrence rate after surgical and endovascular treatment

et al. 2023

Self Cite

View full text Add to dashboard Cite

IntroductionSpinal dural arteriovenous fistula consist of an heterogenous group of vascular malformation often causing severe neurological deficit due to progressive myelopathy. This type of malformation could be associated with subarachnoid or subdural hemorrhage inside the spinal canal. In the English literature surgical treatment is regarded as the best option if compared to endovascular procedure, being the latter associated with an increased risk of relapse despite its less invasiveness.MethodsIn this study a retrospective analysis of 30 patients with spinal dural and epidural fistula associated with perimedullary venous congestion was undertaken. The radiological and clinical presentation of each patient is analyzed, and the grade of myelopathy is classified through the mJOA score.ResultsA total number of 31 out of 41 collected procedures (22 surgery vs. 19 endovascular) were dural fistulas while the remaining 10 were classified as epidural. A 46% recurrence rate for endovascular treatment against 0% for surgical (p-value 0.004) was described for dural fistulas, while in the epidural fistula group the rate of recurrence was 80% and 20% respectively for endovascular and surgery treatment (p-value 0.6).DiscussionAccording to the results, surgical treatment could be considered as first-line treatment for spinal dural arteriovenous fistulas. Endovascular embolization can be proposed in selected cases, as a less invasive technique, for elderly patients or with important comorbidities. In spinal epidural arteriovenous fistulas, in view of the greater invasiveness of the surgical treatment and the non-significant difference in terms of recurrence risk between the two techniques, endovascular treatment could be proposed as a first choice treatment; in the event of a recurrence, a surgical intervention will instead be proposed in a short time.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Spinal dural and epidural arteriovenous fistula: Recurrence rate after surgical and endovascular treatment

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…6 The pathophysiology of SSEH and SAH is not very clear, however, it is described that it can originate after the dissection of a radiculomedullary artery due to increased intraabdominal or thoracic pressure as a result of exertion or after spinal trauma. 8 , 9 …”

Section: Discussionmentioning

confidence: 99%

Dissecting a radiculomedullary artery as an infrequent cause of low back pain: illustrative case

Gómez

Rairan

Ramirez-Arquez

et al. 2023

Journal of Neurosurgery: Case Lessons

View full text Add to dashboard Cite

BACKGROUND There is currently no case described in the literature of epidural hematoma associated with subarachnoid hemorrhage due to dissection of a spontaneous radiculomedullary artery at the lumbar level and therefore its incidence and prevalence are not known. However, its etiology is thought to be similar and may not be diagnosed given its nonspecific symptomatology. OBSERVATIONS The authors present the case of an adult patient who consulted the emergency department for 2 weeks of low back pain. On physical examination there were negative signs of radiculopathy without neurological focalization. The patient was evaluated by neurosurgery via thoracic and lumbosacral spine magnetic resonance imaging, with findings of epidural hematoma associated with subarachnoid hemorrhage in the lumbosacral region. After that, panangiography was done. In the study, it was possible to visualize a dissection of the radicular artery at the L2 level. The patient was not a candidate for surgical management and continued with medical pain management. The patient has a good clinical evolution and was discharged. LESSONS The aim of the present case is to describe a unique case of radiculomedullary artery dissection as a cause of spontaneous epidural hematoma associated with a subarachnoid hemorrhage in the lumbar region.

show abstract

Dorsal subdural hemorrhage from ruptured thoracic radicular artery pseudoaneurysm. case report and surgical video

Cited by 2 publications

References 12 publications

Spinal dural and epidural arteriovenous fistula: Recurrence rate after surgical and endovascular treatment

Spinal dural and epidural arteriovenous fistula: Recurrence rate after surgical and endovascular treatment

Dissecting a radiculomedullary artery as an infrequent cause of low back pain: illustrative case

Contact Info

Product

Resources

About