RT Journal Article SR Electronic T1 Ruptured aneurysm of the artery of Adamkiewicz: is conservative management the standard of treatment in the current era? JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP neurintsurg-2017-013194 DO 10.1136/neurintsurg-2017-013194.rep A1 Pedro Aguilar-Salinas A1 Jussie Lima A1 Leonardo B C Brasiliense A1 Ricardo A Hanel A1 Eric Sauvageau YR 2018 UL http://jnis.bmj.com/content/early/2018/04/06/neurintsurg-2017-013194.rep.abstract AB Spinal aneurysms are rare lesions, and their natural history is not well known. In particular, aneurysms arising from the artery of Adamkiewicz (AA) are an extremely rare phenomenon, and given the lack of solid evidence its management remains unclear. We present the case of a 54-year-old woman with spinal subarachnoid hemorrhage. A spinal angiogram demonstrated a fusiform aneurysm arising from the AA. Based on the location, the absence of evident collateral circulation to the anterior spinal artery, and the available literature supporting spontaneous thrombosis, we opted for conservative management. Fifteen days after the diagnosis, a spinal angiogram demonstrated complete occlusion of the aneurysm with no visualization of the AA. At 10-month follow-up, the patient was able to walk without assistance. Management should be done on a case-by-case basis with the goal of preserving spinal cord perfusion. Similar to previous articles, our report reinforces conservative management as a valid strategy.