anterior_spinal_artery_aneurysm

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 1).

Aneurysms of the anterior spinal artery are extremely rare. Unlike intracranial saccular aneurysms, they do not occur at branch points, are typically pseudoaneurysms, and rupture secondary to a dissection 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12) 13) 14)

They typically present with subarachnoid hemorrhage 15).

Risk factors

Polyarteritis nodosa 16).

Treatment

Clinical and radiographic improvement over time without treatment 17)

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.

1)
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.
2)
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.
3)
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.
4)
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.
5)
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.
6)
Garcia CA, Dulcey S, Dulcey J. Ruptured aneurysm of the spinal artery of Adamkiewicz during pregnancy. Neurology. 1979;29:394-398.
7)
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.
8)
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.
9)
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.
10)
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.
11)
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.
12)
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.
13)
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.
14)
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.
15) , 17)
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.
16)
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.
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