Anterior spinal artery aneurysm [Neurosurgery Wiki]

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====== Anterior spinal artery aneurysm ======


Rupture of an isolated [[spinal artery aneurysm]] is a rare cause of [[subarachnoid haemorrhage]] (SAH) accounting for less than 1% of all cases reported in the literature
((van Gijn J, Kerr RS, Rinkel GJ. Subarachnoid haemorrhage. Lancet. 2007 Jan 27;369(9558):306-18. doi: 10.1016/S0140-6736(07)60153-6. PMID: 17258671.)).

Aneurysms of the anterior spinal artery are extremely rare. Unlike intracranial [[saccular aneurysm]]s, they do not occur at branch points, are typically [[pseudoaneurysm]]s, and rupture secondary to a [[dissection]]
((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;57:1127-1131.))
((Lavoie P, Raymond J, Roy D, Guilbert F, Weill A.
Selective treatment of an anterior spinal artery
aneurysm with endosaccular coil therapy. Case
report. J Neurosurg Spine. 2007;6:460-464.))
((Romero DG, Batista AL, Gentric JC, Raymond J,
Roy D, Weill A. Ruptured isolated spinal artery
aneurysms report of two cases and review of the
literature. Intervent Neuroradiol. 2014;20:774-780.))
((Dabus G, Tosello RT, Pereira BJ, Linfante I,
Piske RL. Dissecting spinal aneurysms: conservative
management as a therapeutic option.
J Neurointervent Surg. 2018;10:451-454.))
((Garcia CA, Dulcey S, Dulcey J. Ruptured aneurysm
of the spinal artery of Adamkiewicz during
pregnancy. Neurology. 1979;29:394-398.))
((Vishteh AG, Brown AP, Spetzler RF. Aneurysm of
the intradural artery of Adamkiewicz treated with
muslin wrapping: technical case report.
Neurosurgery. 1997;40:207-209.))
((Berlis A, Scheufler K-M, Schmahl C, Rauer S,
Götz F, Schumacher M. Solitary spinal artery aneurysms
as a rare source of spinal subarachnoid
hemorrhage: potential etiology and treatment
strategy. Am J Neuroradiol. 2005;26:405-410.))
((Massand MG, Wallace RC, Gonzalez LF,
Zabramski JM, Spetzler RF. Subarachnoid
hemorrhage due to isolated spinal artery aneurysm
in four patients. Am J Neuroradiol. 2005;26:
2415-2419.))
((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 Medchirurg. 2011;51:649-652.))
((Son S, Lee S-G, Park C-W. Solitary ruptured
aneurysm of the spinal artery of Adamkiewicz with
subarachnoid hemorrhage. J Kor Neurosurg Soc.
2013;54:50.))
((Doberstein CA, Bouley A, Silver B, Morrison JF,
Jayaraman MV. Ruptured aneurysms of the
intradural artery of adamkiewicz: angiographic
features and treatment options. Clin Neurol
Neurosurg. 2016;146:152-155.))
((Agarwal A, Weerakkody Y, Marshall M, Singh T.
Intercostal artery pseudoaneurysm with spontaneous
resolution in the setting of an artery of
Adamkiewicz. Case Rep. 2016;2016. bcr2016012802.))
((Aguilar-Salinas P, Lima J, Brasiliense LB,
Hanel RA, Sauvageau E. Ruptured aneurysm of
the artery of Adamkiewicz: is conservative
management the standard of treatment in the
current era? J Neurointervent Surg. 2018;10:e22.)) 

----


They typically present with [[subarachnoid hemorrhage]]
((Cobb M, Griffin A, Karikari I, Gonzalez LF. Endovascular Treatment of Ruptured Enlarging Dissecting Anterior Spinal Artery Aneurysm. World Neurosurg. 2020 Jul;139:e658-e662. doi: 10.1016/j.wneu.2020.04.100. Epub 2020 Apr 24. PMID: 32339730.)).

===== Risk factors =====
[[Polyarteritis nodosa]] 
((Smith G, Hoh BL, Albayram MS. Anterior spinal artery aneurysm presenting with
spinal subarachnoid hemorrhage in a case of polyarteritis nodosa. Clin Imaging.
2019 Jul-Aug;56:108-113. doi: 10.1016/j.clinimag.2019.04.008. Epub 2019 Apr 17.
PMID: 31029009.)).

===== Treatment =====

Clinical and radiographic improvement over time without treatment
((Cobb M, Griffin A, Karikari I, Gonzalez LF. Endovascular Treatment of Ruptured Enlarging Dissecting Anterior Spinal Artery Aneurysm. World Neurosurg. 2020 Jul;139:e658-e662. doi: 10.1016/j.wneu.2020.04.100. Epub 2020 Apr 24. PMID: 32339730.))

[[Anterior spinal artery aneurysm treatment]],
43: Koch M, Sepp D, Prothmann S, Poppert H, Seifert CL. Systemic thrombolysis in
anterior spinal artery syndrome: what has to be considered? J Thromb
Thrombolysis. 2016 Apr;41(3):511-3. doi: 10.1007/s11239-015-1281-8. PMID:
26386968.

===== Case reports =====

[[Anterior spinal artery aneurysm case reports]].