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BMC Neurology
Published in: BMC Neurology 1/2021

Open Access 01-12-2021 | Subarachnoid Hemorrhage | Case report

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

Authors: Alexander Tenorio, Brandon B. Holmes, Adib A. Abla, Matthew Amans, Karl Meisel

Published in: BMC Neurology | Issue 1/2021

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Abstract

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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Metadata
Title
An isolated ruptured spinal aneurysm presents with a thalamic Infarct: case report
Authors
Alexander Tenorio
Brandon B. Holmes
Adib A. Abla
Matthew Amans
Karl Meisel
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2021
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-021-02055-5

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