Spinal aneurysm of the lateral sacral artery

Alberstone, Cary D.; Rupp, Frederick W.; Anson, John A.

doi:10.3171/spi.2000.92.1.0101

Cited by 10 publications

(10 citation statements)

References 13 publications

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“…4 There may be significant technical difficulty in catheterizing the small spinal vessels that have lower flow rates than the cranial vessels, and surgery may be the best option in such a situation. 2,45,81 The other issue arises when the aneurysmal sac is very large in size. Some authors have reported the deployment of as many as 38 complex helical coils into the cavity of an SA.…”

Section: Therapymentioning

confidence: 99%

“…Patients usually present with cauda equina syndrome. 2,11,74,86 Autosomal dominant polycystic kidney disease is well known to be associated with renal failure and cerebral aneurysms. Such an association could not be established for SAs.…”

Section: Spinal Aneurysms With Associated Conditions Other Than Avmmentioning

confidence: 99%

“…Two patients had undergone renal transplants for proliferative glomerulonephritis leading to renal failure. 2,11 Data indicating the reason for renal transplant was not available in the other 3 case reports. 74,86,95 Disease processes that cause weakening of the vessel wall (connective tissue disorders, infections, trauma, vasculitis, and so on) could also generate an SA.…”

Section: Spinal Aneurysms With Associated Conditions Other Than Avmmentioning

confidence: 99%

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Spinal aneurysms: clinicoradiological features and management paradigms

Madhugiri

Ambekar

Kumar

et al. 2013

SPI

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Object Spinal aneurysms (SAs) are rare lesions. The clinicoradiological features and the exact degree of their association with comorbid conditions such as arteriovenous malformations (AVMs) and coarctation of the aorta have not been definitively described. The ideal management paradigm has not been established. The authors reviewed literature to determine the clinical patterns of presentation, management, and outcome of spinal aneurysms. Methods A systematic review of literature was performed using 23 separate strings. A total of 10,190 papers were screened to identify 87 papers that met the inclusion criteria. A total of 123 SAs could be included for analysis. Results The mean age of patients at presentation was 38 years; 10% of patients were aged less than 10 years and nearly 50% were greater than 38 years. Spinal aneurysms can be divided into 2 groups: those associated with AVMs (SA-AVMs, or Type 1 SAs) and those with isolated aneurysms (iSAs, or Type 2 SAs). Patients with Type 2 SAs were older and more likely to present with bleeding than those with Type 1 SAs. The acute syndromes can be divided into 3 groups of patients: those with spinal syndrome, those with cranial/craniospinal syndrome, and those with nonspecific presentation. Overall, 32.6% presented with angiography-negative cranial subarachnoid hemorrhage (SAH). Presentation with evidence of cord dysfunction (myelopathy/weakness/sensory loss/bladder involvement) correlated with poor outcome, as did presentation with hemorrhage and association with other comorbid conditions. Surgery and endovascular therapy both led to comparable rates of complete aneurysm obliteration for Type 2 SAs, whereas for the AVM-associated Type 1 SAs, surgery led to better rates of lesion obliteration. The authors propose a classification scheme for spinal aneurysms based on whether the lesion is solitary or is associated with a coexistent spinal AVM; this would also imply that the ideal therapy for the aneurysm would differ based on this association. Conclusions The clinical and radiological patterns that influence outcome are distinct for Type 1 and Type 2 SAs. The ideal treatment for Type 1 SAs appears to be excision, whereas surgery and endovascular therapy were equally effective for Type 2 SAs.

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Section: Therapymentioning

confidence: 99%

Section: Spinal Aneurysms With Associated Conditions Other Than Avmmentioning

confidence: 99%

Section: Spinal Aneurysms With Associated Conditions Other Than Avmmentioning

confidence: 99%

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Spinal aneurysms: clinicoradiological features and management paradigms

Madhugiri

Ambekar

Kumar

et al. 2013

SPI

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“…From the current study it is clear that the lateral sacral artery supplies the sacral roots during its course. However, the possibility of lateral sacral artery aneurysm associated with thrombosis [18] would create direct pressure and/or impairment of the collateral circulation [19,20] to the sciatic nerve roots potentially giving rise to radiculopathy or acute low back pain [18]. Moreover, prolonged ligation of the internal iliac artery and its trunk may reduce the blood supply to the sciatic sacral nerve roots leading to sciatic neuropathy presenting with sciatic symptoms [18][19][20][21].…”

Section: Iiamentioning

confidence: 99%

Variation of the Lateral Sacral Artery in relation to Sciatic Neuropathy

Talalwah

Dorazi

Soames

2014

Advances in Anatomy

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The lateral sacral artery usually originates from the posterior trunk of the internal iliac artery. The current study of 342 specimens from 171 cadavers (79 male, 92 female) investigated the origin and course of the lateral sacral artery. It was observed to arise from the posterior trunk in 79.1%. Occasionally it originated from the anterior trunk that occurred in 1%. It arose from the sciatic artery in 8.8%, from the superior gluteal artery in 16.8%, and from the inferior gluteal artery in 5.4%. Conversely, the lateral sacral artery is congenital absence in 0.3%. In addition, the lateral sacral artery was single, double, triple, and quadruple in 77.2%, 19.8%, 2.3%, and 0.3%, respectively. Consequently, variability of the lateral sacral artery origin is due to vascular demand as the lateral sacral artery plexus does arise from the earlier trunk development. With variability of the lateral sacral artery origin, there is a variability of the sciatic nerve supply. Knowing the variability of origins, surgeons have to avoid prolonged ligation of the internal iliac artery or its posterior trunk during surgical procedures which may lead to sciatic neuropathy. Therefore, the lateral sacral artery origin, course, and branches are important for clinicians to improve their knowledge and patient management.

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“…The most common presentation, acute low back pain with radiculopathy, is associated with an LSAA rupture. Alternatively, subacute presentation has been described relating to mass effect from aneurysmal dilatation of the vessel 1. It is notable that all cases reported to date have been associated with aneurysm formation posterior to the first sacral vertebral body.…”

Section: Discussionmentioning

confidence: 99%