Abstract
Background:Isolated cervical anterior spinal artery aneurysms are extremely rare. Subarachnoid hemorrhage (SAH) secondary to such lesions have been described only in six cases to the best of our knowledge.Case Description:We describe an unusual clinical picture of SAH due to rupture of anterior spinal artery aneurysm in a patient with previous normal angiogram. Due to the location of the aneurysm and clinical status of the patient, conservative management was proposed, and she was discharged to further follow-up. Monthly routine angiograms revealed resolution of the aneurysm 90 days after bleeding, which was highly suggestive of vascular dissection.Conclusion:We highlight the need to consider these aneurysms in the differential diagnosis of SAH, especially when occurring in the posterior fossa and when angiography findings are inconclusive.
Highlights
Isolated cervical anterior spinal artery aneurysms are extremely rare
We report an unusual clinical picture of Subarachnoid hemorrhage (SAH) due to rupture of anterior spinal artery (ASA) aneurysm in a patient with a previously normal angiogram, and highlight the need to consider this entity in the differential diagnosis of SAH of unknown etiology
computed tomography (CT) angiography performed at the same time could not display the aneurysm clearly [Figure 2]
Summary
Felix Hendrik Pahl, Matheus Fernandes de Oliveira, Marcus Alexandre Cavalcanti Rotta, Guilherme Marcos Soares Dias, André Luiz Rezende, José Marcus Rotta. Available FREE in open access from: http://www.surgicalneurologyint.com/text.asp?2014/5/1/139/141776
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