Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Neurocritical Care
Published in: Neurocritical Care 2/2015

01-04-2015 | Practical Pearl

A Cause of Atypical Intracranial Subarachnoid Hemorrhage: Posterior Spinal Artery Aneurysms

Published in: Neurocritical Care | Issue 2/2015

Login to get access

Abstract

Background

Approximately 1 % of cases of intracranial subarachnoid hemorrhage (SAH) are caused by spinal vascular pathologies. Among them, isolated spinal artery aneurysms are uncommon and a limited number of cases have been reported in the literature.

Methods

This is a report of two cases and review of the literature.

Results

Both patients presented with an atypical intracranial SAH and were also found to have spinal SAH caused by a ruptured posterior spinal aneurysm.

Conclusion

Isolated spinal artery aneurysms represent a rare cause of intracranial SAH. Symptoms such as back pain and lower-extremity weakness can be clues to the adequate diagnosis. Surgical or endovascular treatment should be pursued in all patients, as the risk of rebleeding is non-negligible.
Literature
1.
2.
Carvi y Nievas MN, Archavlis E. Atypical causes of nontraumatic intracranial subarachnoid hemorrhage. Clin Neurol Neurosurg. 2009;111:354–8.CrossRefPubMed
3.
Lucas JW, Jones J, Farin A, Kim P, Giannotta SL. Cervical spine dural arteriovenous fistula with coexisting spinal radiculopial artery aneurysm presenting as subarachnoid hemorrhage: case report. Neurosurgery. 2012;70:E259–63 discussion E63.CrossRefPubMed
4.
Djindjian R. Angiography of the spinal cord. Surg Neurol. 1974;2:179–85.PubMed
5.
Rengachary SS, Duke DA, Tsai FY, Kragel PJ. Spinal arterial aneurysm: case report. Neurosurgery. 1993;33:125–9 discussion 9-30.CrossRefPubMed
6.
Gonzalez LF, Zabramski JM, Tabrizi P, Wallace RC, Massand MG, Spetzler RF. Spontaneous spinal subarachnoid hemorrhage secondary to spinal aneurysms: diagnosis and treatment paradigm. Neurosurgery. 2005;57:1127–31 discussion -31.CrossRefPubMed
7.
Kim HJ, Choi IS. Dissecting aneurysm of the posterior spinal artery: case report and review of the literature. Neurosurgery. 2012;71:E749–56 discussion E56.CrossRefPubMed
8.
Berlis A, Scheufler KM, Schmahl C, Rauer S, Gotz F, Schumacher M. Solitary spinal artery aneurysms as a rare source of spinal subarachnoid hemorrhage: potential etiology and treatment strategy. AJNR Am J Neuroradiol. 2005;26:405–10.PubMed
9.
Cavusoglu H, Ozdilmac A, Sahin Y, Aydin Y. Isolated posterior spinal artery aneurysm causing intracranial acute subarachnoidal hemorrhage. Acta Neurochir (Wien). 2010;152:721–4.CrossRef
10.
Geibprasert S, Krings T, Apitzsch J, Reinges MH, Nolte KW, Hans FJ. Subarachnoid hemorrhage following posterior spinal artery aneurysm. A case report and review of the literature. Interv Neuroradiol. 2010;16:183–90.PubMedCentralPubMed
11.
Goto Y, Kamijyo Y, Yonekawa Y, Kikuchi H. Ruptured aneurysm of the posterior spinal artery of the upper cervical spinal cord: case report. Neurosurgery. 1988;22:558–60.CrossRefPubMed
12.
Kocak A, Ates O, Cayli SR, Sarac K. Isolated posterior spinal artery aneurysm. Br J Neurosurg. 2006;20:241–4.CrossRefPubMed
13.
Handa T, Suzuki Y, Saito K, Sugita K, Patel SJ. Isolated intramedullary spinal artery aneurysm presenting with quadriplegia. Case report. J Neurosurg. 1992;77:148–50.CrossRefPubMed
14.
Henson RA, Croft PB. Spontaneous spinal subarachnoid haemorrhage. Q J Med. 1956;25:53–66.PubMed
15.
Nemecek AN, Sviri G, Hevner R, Ghodke B, Britz GW. Dissecting aneurysm of the thoracic posterior spinal artery. Case illustration. J Neurosurg Spine. 2006;5:555.CrossRefPubMed
16.
Shankar JJ, TerBrugge K, Krings T. Subarachnoid hemorrhage following posterior spinal artery aneurysm rupture. Can J Neurol Sci. 2012;39:531–2.CrossRefPubMed
17.
Cai X, Liu C, Hu K, Chen Z, Wang Y, Fang W. A case report of posterior spinal artery aneurysm. Chin Med J (Engl). 1998;111:1051–3.
18.
Tanweer O, Woldenberg R, Zwany S, Setton A. Endovascular obliteration of a ruptured posterior spinal artery pseudoaneurysm. J Neurosurg Spine. 2012;17:334–6.CrossRefPubMed
19.
Kurita M, Endo M, Kitahara T, Fujii K. Subarachnoid haemorrhage due to a lateral spinal artery aneurysm misdiagnosed as a posterior inferior cerebellar artery aneurysm: case report and literature review. Acta Neurochir (Wien). 2009;151:165–9.CrossRef
20.
Karakama J, Nakagawa K, Maehara T, Ohno K. Subarachnoid hemorrhage caused by a ruptured anterior spinal artery aneurysm. Neurol Med Chir (Tokyo). 2010;50:1015–9.CrossRef
21.
Iihoshi S, Miyata K, Murakami T, Kaneko T, Koyanagi I. Dissection aneurysm of the radiculomedullary branch of the artery of Adamkiewicz with subarachnoid hemorrhage. Neurol Med Chir (Tokyo). 2011;51:649–52.CrossRef
22.
Vincent FM. Anterior spinal artery aneurysm presenting as a subarachnoid hemorrhage. Stroke. 1981;12:230–2.CrossRefPubMed
23.
Moore DW, Hunt WE, Zimmerman JE. Ruptured anterior spinal artery aneurysm: repair via a posterior approach. Neurosurgery. 1982;10:626–30.CrossRefPubMed
24.
Mohsenipour I, Ortler M, Twerdy K, Schmutzhard E, Attlmayr G, Aichner F. Isolated aneurysm of a spinal radicular artery presenting as spinal subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry. 1994;57:767–8.CrossRefPubMedCentralPubMed
25.
Kawamura S, Yoshida T, Nonoyama Y, Yamada M, Suzuki A, Yasui N. Ruptured anterior spinal artery aneurysm: a case report. Surg Neurol. 1999;51:608–12.CrossRefPubMed
26.
Chen CC, Bellon RJ, Ogilvy CS, Putman CM. Aneurysms of the lateral spinal artery: report of two cases. Neurosurgery. 2001;48:949–53 discussion 53-4.PubMed
27.
Massand MG, Wallace RC, Gonzalez LF, Zabramski JM, Spetzler RF. Subarachnoid hemorrhage due to isolated spinal artery aneurysm in four patients. AJNR Am J Neuroradiol. 2005;26:2415–9.PubMed
28.
Toyota S, Wakayama A, Fujimoto Y, Sugiura S, Yoshimine T. Dissecting aneurysm of the radiculomedullary artery originating from extracranial vertebral artery in a patient with rheumatoid cervical spine disease: an unusual case of subarachnoid hemorrhage. J Neurosurg Spine. 2007;7:660–3.CrossRefPubMed
29.
Klingler JH, Glasker S, Shah MJ, Van Velthoven V. Rupture of a spinal artery aneurysm attributable to exacerbated Sjogren syndrome: case report. Neurosurgery. 2009;64:E1010–1 discussion E1.CrossRefPubMed
30.
Pollock JM, Powers AK, Stevens EA, Sanghvi AN, Wilson JA, Morris PP. Ruptured anterior spinal artery aneurysm: a case report. J Neuroimaging. 2009;19:277–9.CrossRefPubMed
31.
Metadata
Title
A Cause of Atypical Intracranial Subarachnoid Hemorrhage: Posterior Spinal Artery Aneurysms
Publication date
01-04-2015
Published in
Neurocritical Care / Issue 2/2015
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-014-0009-5

Other articles of this Issue 2/2015

Neurocritical Care 2/2015 Go to the issue

Original Article

Predictors of Nosocomial Pneumonia in Intracerebral Hemorrhage Patients: A Multi-center Observational Study

Original Article

Rapid Unexpected Brain Herniation in Association with Renal Replacement Therapy in Acute Brain Injury: Caution in the Neurocritical Care Unit

Translational Research

Modeling the Pattern of Contrast Extravasation in Acute Intracerebral Hemorrhage Using Dynamic Contrast-Enhanced MR

Original Article

Non-convulsive Status Epilepticus and Non-convulsive Seizures in Neurological ICU Patients

Practical Pearl

Dialysis-Induced Worsening of Cerebral Edema in Intracranial Hemorrhage: A Case Series and Clinical Perspective

Editorial

A Brain–Kidney Connection: The Delicate Interplay of Brain and Kidney Physiology