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Hemorrhagic Stroke
Case series
Spinal artery aneurysms: clinical presentation, radiological findings and outcome
  1. Leonardo Renieri1,
  2. Eytan Raz2,
  3. Giuseppe Lanzino3,
  4. Timo Krings1,
  5. Maksim Shapiro2,
  6. Peyman Shirani2,
  7. Waleed Brinjikji1,3
  1. 1 Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
  2. 2 Department of Radiology, New York University Langone Medical Center, New York City, New York, USA
  3. 3 Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Dr Leonardo Renieri, Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, ON M5G 1L7, Canada; leonardo.renieri{at}hotmail.it

Abstract

Background and purpose Spinal arterial aneurysms are a rare cause of spinal subarachnoid hemorrhage (SAH). We performed a retrospective review of spinal arterial aneurysms not associated with spinal arteriovenus shunts from three institutions in order to better understand the clinical and imaging characteristics of these lesions.

Materials and methods We performed a retrospective review of spinal arterial aneurysms managed at three North American institutions. For each patient, the following information was collected: demographic data, clinical presentation, comorbidities, imaging findings, and neurological status at the last follow-up. Treatment strategies and outcomes were reported.

Results 11 patients were included; 7 were women and median age was 60 years. The most common presentation was sudden back pain (81.8%). We found 3 aneurysms on the radiculomedullary artery and 8 along the radiculopial arteries. Of the 3 aneurysms on the radiculomedullary artery, 1 was treated conservatively, 1 was treated with coiling of the aneurysm and sacrifice of the radiculomedullary artery, and 1 was treated with surgical trapping. The 8 aneurysms on the radiculopial artery were treated endovascularly in 4 cases, surgically in 1 case, and conservatively in 3 cases. One surgically treated patient had a spinal subdural hematoma. There were no other complications. Mean clinical follow-up time was 20 months, and 87.5% of patients were functionally independent.

Conclusions Spinal arterial aneurysms are lesions which commonly present with sudden back pain and spinal SAH. Conservative, surgical, and endovascular treatment options are safe and effective. Long term outcomes in these patients are generally good.

  • aneurysm
  • dissection
  • hemorrhage
  • spinal cord

https://doi.org/10.1136/neurintsurg-2017-013687

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    Footnotes

    • Contributors LR, ER, and WB collected the data and contributed to the analysis. GL, TK, MS, and PS contributed to the interpretation of the data for the work. All authors contributed to drafting and revising the paper, and gave their final approval. They agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Competing interests None declared.

    • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

    • Ethics approval The study was approved by the institutional review board.

    • Provenance and peer review Not commissioned; externally peer reviewed.