Multiple aneurysms of thoracic spinal cord arteries presenting with spinal infarction and subarachnoid hemorrhage: Case report and literature review

Kenichi Sato, Luca Roccatagliata, Sebastien Depuydt, Georges Rodesch

    Research output: Contribution to journalReview articlepeer-review

    19 Citations (Scopus)

    Abstract

    BACKGROUND AND IMPORTANCE: Arterial aneurysms of the spinal cord are rare. Their pathogenesis is variable, and the therapeutic strategies remain controversial, because their natural history is unclear. We report a case of multiple dissecting aneurysms of radiculomedullary and radiculopial arteries presenting with spinal infarction and subarachnoid hemorrhage, which spontaneously resolved. CLINICAL PRESENTATION: A 67-year-old woman was hospitalized owing to sudden onset of severe back pain with discomfort in the lower extremities. Two days later, she again experienced sudden back pain accompanied by paraparesis and sphincter disturbance. Magnetic resonance imaging of the thoracic spinal cord showed 2 intradural masses of heterogeneous intensity at the levels of T-8 and T-10, spinal infarction, and subarachnoid hemorrhage. Spinal angiography revealed a "pearls and strings" aspect of a radiculomedullary artery arising from the left T-11 and a fusiform aneurysm of a radiculopial artery arising from the left T-8. Infectious and immunological evaluations failed to show any anomaly. Spontaneous dissections were suspected. Conservative treatment was proposed, and the patient's clinical course remained uneventful. Follow-up magnetic resonance imaging and spinal angiography performed 2 months after onset showed disappearance of both arterial lesions. CONCLUSION: Arterial dissections of spinal radicular arteries can resolve spontaneously and be managed conservatively. We propose a classification of the pathogenesis of spinal arterial aneurysm to clarify appropriate treatment strategies by a literature review.

    Original languageEnglish
    Pages (from-to)E1053-E1058
    JournalNeurosurgery
    Volume71
    Issue number5
    DOIs
    Publication statusPublished - 2012 Nov

    Keywords

    • Aneurysms
    • Dissection
    • Infarction
    • Radicular artery
    • Spinal cord
    • Subarachnoid hemorrhage

    ASJC Scopus subject areas

    • Surgery
    • Clinical Neurology

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