An Isolated Posterior Spinal Aneurysm Resection in Which Intraoperative Electrophysiological Monitoring Was Successfully Used to Locate the Lesion and to Detect the Possibility of Ischemic Complications

Takata, Megumu; Takayama, Motohiro; Yokoyama, Yayoi; Hayashi, Hideki; Kishida, Natsue

doi:10.1097/brs.0000000000001081

Cited by 8 publications

(2 citation statements)

References 5 publications

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“… 3 , 11 Adjunctive neuromonitoring has been described in addition to the use of intraoperative indocyanine green (ICG), although in cases with thrombosed aneurysms at the time of surgery, ICG has limited utility. 11 , 13 , 20 Furthermore, 2 cases were found to have spontaneously regressed either through parent vessel thrombosis or lack of aneurysm at surgery. 6 , 21 If anatomical restrictions preclude clipping or the lesion is closely associated with the artery of Adamkiewicz, the anterior spinal artery, or the PSA and the risk of periprocedural cord infarct is high, wrapping aneurysms with muslin or direct vessel reconstruction has been described previously.…”

Section: Discussionmentioning

confidence: 99%

Posterior spinal artery aneurysm as an unlikely culprit for perimesencephalic pattern subarachnoid hemorrhage: illustrative case

Malhotra¹,

Ku²,

Pereira

et al. 2021

Journal of Neurosurgery: Case Lessons

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BACKGROUND Angiogram-negative nontraumatic subarachnoid hemorrhage (SAH) can be diagnostically challenging, and a broad differential diagnosis must be considered. Particular attention to initial radiographic hemorrhage distribution is essential to guide adjunctive investigations. Posterior spinal artery aneurysms are rare clinical entities with few reported cases in the literature. An understanding of isolated spinal artery aneurysm natural history, diagnosis, and management is evolving as more cases are identified. OBSERVATIONS Isolated thoracic posterior spinal artery aneurysm can be the culprit lesion in perimesencephalic distribution SAH. Embolization resulted in complete aneurysm occlusion and did not result in periprocedural morbidity. At the 1-year follow-up, the patient was neurologically intact with no recurrence on magnetic resonance angiography. LESSONS This case report highlighted the presentation, diagnostic workup, clinical decision-making, and endovascular intervention for a woman who presented with SAH secondary to posterior spinal artery aneurysm. After initially negative results on vascular imaging, dedicated spinal vascular imaging revealed the location of the aneurysm. Multiple treatment modalities exist for isolated spinal artery aneurysms and must be selected on the basis of patient- and lesion-specific characteristics.

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Section: Discussionmentioning

confidence: 99%

Posterior spinal artery aneurysm as an unlikely culprit for perimesencephalic pattern subarachnoid hemorrhage: illustrative case

Malhotra¹,

Ku²,

Pereira

et al. 2021

Journal of Neurosurgery: Case Lessons

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“…However, Takata et al recently presented a case of isolated PSA aneurysm in which motor evoked potential was deteriorated by temporary clipping of the PSA. 14) …”

Section: Discussionmentioning

confidence: 99%

Successfully Treated Isolated Posterior Spinal Artery Aneurysm Causing Intracranial Subarachnoid Hemorrhage: Case Report

Horio

Katsuta

Samura

et al. 2015

Neurol. Med. Chir.(Tokyo)

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There are very few published reports of rupture of an isolated posterior spinal artery (PSA) aneurysm, and consequently the optimal therapeutic strategy is debatable. An 84-year-old man presented with sudden onset of restlessness and disorientation. Neuroradiological imaging showed an intracranial subarachnoid hemorrhage (SAH) with no visible intracranial vascular lesion. Spinal magnetic resonance imaging (MRI) detected a localized subarachnoid hematoma at Th10–11. Both contrast-enhanced spinal computed tomography and enhanced MRI and magnetic resonance angiography revealed an area of enhancement within the hematoma. Superselective angiography of the left Th12 intercostal artery demonstrated a faintly enhanced spot in the venous phase. Thirteen days after the onset of symptoms, a small fusiform aneurysm situated on the radiculopial artery was resected. The patient's postoperative course was uneventful and he was eventually discharged in an ambulatory condition. To our knowledge, this 84-year-old man is the oldest reported case of surgical management of a ruptured isolated PSA aneurysm. This case illustrates both the validity and efficacy of this therapeutic approach.

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Isolated aneurysms of the spinal circulation: a systematic review of the literature

Alomari

Huang

et al. 2021

Neurosurg Rev

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An Isolated Posterior Spinal Aneurysm Resection in Which Intraoperative Electrophysiological Monitoring Was Successfully Used to Locate the Lesion and to Detect the Possibility of Ischemic Complications

Cited by 8 publications

References 5 publications

Posterior spinal artery aneurysm as an unlikely culprit for perimesencephalic pattern subarachnoid hemorrhage: illustrative case

Posterior spinal artery aneurysm as an unlikely culprit for perimesencephalic pattern subarachnoid hemorrhage: illustrative case

Successfully Treated Isolated Posterior Spinal Artery Aneurysm Causing Intracranial Subarachnoid Hemorrhage: Case Report

Isolated aneurysms of the spinal circulation: a systematic review of the literature

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