Successfully Treated Isolated Posterior Spinal Artery Aneurysm Causing Intracranial Subarachnoid Hemorrhage: Case Report

Horio, Yoshinobu; Katsuta, Toshiro; Samura, Kazuhiro; Wakuta, Naoki; Fukuda, Kenji; Higashi, Toshio; Inoue, Tatsuo

doi:10.2176/nmc.cr.2015-0210

Cited by 11 publications

(3 citation statements)

References 20 publications

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“…Recognizing variations in PSA origins is relevant to surgical approaches for the cervical spine, cranioaxial junction, and posterior cranial fossa, and for VA aneurism embolization. PSAs themselves can develop aneurysms, the rupture of which has been reported to cause subarachnoid hemorrhages (Horio et al, ; Ronchetti et al, ).…”

Section: Discussionmentioning

confidence: 99%

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Variable anatomic configuration of the posterior spinal arteries in humans

2018

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Posterior spinal arteries (PSAs) arise from the vertebral (VA) or posterior inferior cerebellar (PICA) artery. We identified variations in their origins and their anastomosis with the first posterior radiculomedullary branches in human spinal cords. Spinal cords from male and female cadavers (n = 30) were injected with colored latex through the vertebral, ascending cervical, costocervical trunk and segmental arteries. Specimens were fixed in formalin and the spinal arteries were dissected under a surgical microscope. PSAs arise from the PICA and from the atlantoaxial (V3) or intracranial (V4) segments of the VA. Their origins can be at V3 between the axis and the transverse processes of the atlas (V3i) or between the processes and the occipital bone (V3s). Half of our specimens exhibited a symmetrical and half an asymmetrical origin of the PSAs. A symmetrical origin from V4 was the most common configuration, identified in 30% of specimens. There was a symmetrical origin from either segment of V3 or PICA in 10%. Asymmetrical configurations were observed from V4/V3 (23.7%), V3/PICA (16.7%), V4/PICA (6.7%) and V3i/V3s (3.3%). PSAs are supplied by the posterior radiculomedullary arteries along the spinal cord. The first of these anastomoses could be located at any level between C4 and T8, though most commonly at C6-C7 or T3-T4. PSAs can originate from either the VA or the PICA in a symmetrical or asymmetrical configuration. Variations in the origin and level of the first posterior radiculomedullary anastomosis could affect surgical approaches, endovascular procedures, and the posterior spinal cord's susceptibility to ischemia. Clin. Anat., 2018. © 2018 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

“…PICA) posterior inferior cerebellar artery. cause subarachnoid hemorrhages (Horio et al, 2015;Ronchetti et al, 2015). Dorsal components of the spinal cord are less susceptible to ischemic injury than ventral components.…”

Section: Discussionmentioning

confidence: 99%

Variable anatomic configuration of the posterior spinal arteries in humans

2018

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“…We report a case of a patient with a spinal subarachnoid hemorrhage caused by rupture of an isolated posterior spinal artery aneurysm that was surgically corrected. The patient also presented with a concurrent thalamic infarct which has only been described in the literature once before [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

An isolated ruptured spinal aneurysm presents with a thalamic Infarct: case report

et al. 2021

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Background Isolated spinal artery aneurysms are extremely rare, and their pathogenesis, clinical presentation, and treatment strategies are poorly established. We report only the second case of a patient with an isolated posterior spinal aneurysm and concurrent left thalamic infarct and review the literature to help clarify treatment strategies of isolated spinal aneurysms. Case presentation A 49-year-old patient presented with acute onset walking difficulty followed by diaphoresis, back and abdominal pain, and paraplegia. Imaging was notable for a hemorrhagic spinal lesion with compression at T12 through L4 and an acute left thalamic infarct. Surgical exploration revealed an isolated posterior spinal artery aneurysm. The aneurysm was surgically resected and the patient had partial recovery six months post-operatively. Conclusions Isolated posterior spinal artery aneurysms of the thoracolumbar region are rare lesions that commonly present with abdominal pain, radiating back pain, and lower extremity weakness. Imaging may not provide a definitive diagnosis. The three primary treatment strategies are conservative management, endovascular treatment, or surgical resection. In patients with symptomatic cord compression, immediate surgical intervention is indicated to preserve neurologic function. In all other cases, the artery size, distal flow, morphology, and location may guide management.

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Intracranial subarachnoid hemorrhage resulting from non-cervical spinal arteriovenous lesions: Analysis of possible cause of bleeding and literature review

Wang

et al. 2019

Clinical Neurology and Neurosurgery

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Successfully Treated Isolated Posterior Spinal Artery Aneurysm Causing Intracranial Subarachnoid Hemorrhage: Case Report

Cited by 11 publications

References 20 publications

Variable anatomic configuration of the posterior spinal arteries in humans

Variable anatomic configuration of the posterior spinal arteries in humans

An isolated ruptured spinal aneurysm presents with a thalamic Infarct: case report

Intracranial subarachnoid hemorrhage resulting from non-cervical spinal arteriovenous lesions: Analysis of possible cause of bleeding and literature review

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