Ruptured Spinal Aneurysms: Diagnosis and Management Paradigms

Abdalkader, Mohamad; Samuelsen, Brian T.; Moore, Justin M.; Cervantes‐Arslanian, Anna M.; Ong, Charlene; Setty, Bindu N.; Mian, Asim; Nguyen, Thanh N.

doi:10.1016/j.wneu.2020.10.098

Cited by 12 publications

(8 citation statements)

References 32 publications

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“…Diagnosis of SAs is challenging because of their small size, dynamic nature, and atypical shape. To our knowledge, all previously reported SAs cases were solitary, 1,2 and this is the first report of 3 concomitant SAs. Furthermore, subdural hematoma has not been reported as a presenting sign of SAs that typically present with subarachnoid hemorrhage.…”

mentioning

confidence: 62%

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Acute Spinal Subdural Hematoma in a Patient With Multiple Spinal Aneurysms

Abdalkader

Shulman

Sahoo

et al. 2023

Stroke

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mentioning

confidence: 62%

“…3 The spontaneous resolution of the SAs highlights that conservative management may be a potential safe alternative to invasive interventions to manage SAs. 1…”

mentioning

confidence: 99%

Acute Spinal Subdural Hematoma in a Patient With Multiple Spinal Aneurysms

Abdalkader

Shulman

Sahoo

et al. 2023

Stroke

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“…ASA aneurysms are rare and are mainly located in the upper cervical segment (4,(79)(80)(81)(82). They are typically dissections and can be divided into isolated and flow-related types (83,84).…”

Section: Cervical Asa Aneurysmmentioning

confidence: 99%

“…The cervical anterior spinal artery (ASA) arises from the intracranial vertebral artery (VA) and provides blood to the anterior two-thirds of the spinal cord (1). It may be involved in many cervical spinal vascular diseases, such as arteriovenous fistula (AVF), arteriovenous malformation (AVM), and aneurysm (2)(3)(4). In addition, in VA occlusion or the subclavian steal phenomenon, the cervical ASA can serve as a collateral channel (5).…”

Section: Introductionmentioning

confidence: 99%

Role of the Cervical Anterior Spinal Artery in the Endovascular Treatment of Vascular Diseases: Bystander, Accomplice, Victim, or Friend?

Zhang

Hou

et al. 2021

Front. Neurol.

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The cervical anterior spinal artery (ASA) is a very important artery arising from the intracranial vertebral artery (VA). It can play different roles in endovascular treatment (EVT) of spinal vascular diseases. The current understanding of these roles is incomplete; therefore, we performed this review. We found that cervical ASA can be involved in many spinal vascular diseases, such as arteriovenous fistula (AVF), arteriovenous malformation (AVM), and aneurysm, and can serve as a collateral channel in proximal VA occlusion. In AVF and AVM, when the cervical ASA is involved, it often plays the role of an accomplice or victim because it acts as the feeder or as a bystander that does not provide blood flow to the AVF and AVM. In cervical ASA aneurysm, the ASA is a victim. During EVT of VA aneurysms or stenoses, the cervical ASA ostia can be covered or occluded, resulting in ASA ischemia. In this situation, the ASA is a victim. In VA occlusion or the subclavian steal phenomenon, the cervical ASA can serve as a collateral channel to provide blood flow to the posterior circulation. In this case, the ASA plays the role of a friend. According to the role of the cervical ASA in spinal vascular diseases, EVT should be determined “case by case.” Most importantly, when EVT is performed to treat these diseases, the cervical ASA axis must be preserved. Therefore, understanding the role of the cervical ASA in spinal vascular diseases is crucial.

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“…They typically manifest with severe back pain due to rupture and spinal subarachnoid hemorrhage, a condition referred to as "le coup de poignard rachidien." [1][2][3][4][5] We report a case in a man in his late 40s who presented after experiencing sudden, intense interscapular electric shock-like pain that progressed to paraplegia and complete sensory loss below the T5 level. Within 6 hours, the patient regained intact neurological function.…”

mentioning

confidence: 99%

Clip Reconstruction of a Ruptured Thoracic Anterior Spinal Artery Aneurysm Utilizing a Costotransversectomy Approach: 2-Dimensional Operative Video

Farber,

Rahmani,

Scherschinski

et al. 2023

Operative Neurosurgery

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Anterior spinal artery (ASA) aneurysms are exceptionally rare and challenging to diagnose. They typically manifest with severe back pain due to rupture and spinal subarachnoid hemorrhage, a condition referred to as "le coup de poignard rachidien." [1][2][3][4][5] We report a case in a man in his late 40s who presented after experiencing sudden, intense interscapular electric shock-like pain that progressed to paraplegia and complete sensory loss below the T5 level. Within 6 hours, the patient regained intact neurological function. Spinal magnetic resonance imaging revealed subarachnoid hemorrhage at the T4 level. Diagnostic digital subtraction angiography pinpointed a dolichoectatic aneurysm originating from the left ASA at the T5 level. The patient consented to surgical hematoma evacuation for spinal decompression and aneurysm clip reconstruction. The patient required a T4 costotransversectomy with T3-5 fusion to access the ventral spinal canal. Hematoma evacuation aided in exposing the ASA and facilitated proximal and distal control of the aneurysm. The ASA aneurysm was clip-reconstructed using a curved clip, with a second, curved miniclip placed on the opposite side to reconstruct the ASA lumen. Intraoperative indocyanine green videoangiography confirmed patency of the ASA and adequate aneurysm occlusion, with postoperative digital subtraction angiography validating these findings. The patient remained neurologically intact after the operation. This video demonstrates surgical clip reconstruction of a dolichoectatic ASA aneurysm using a costotransversectomy with fusion, highlighting the distinctive clinical and radiographic characteristics of ASA aneurysms and presenting contemporary management strategies for this rare condition.

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Ruptured Spinal Aneurysms: Diagnosis and Management Paradigms

Cited by 12 publications

References 32 publications

Acute Spinal Subdural Hematoma in a Patient With Multiple Spinal Aneurysms

Acute Spinal Subdural Hematoma in a Patient With Multiple Spinal Aneurysms

Role of the Cervical Anterior Spinal Artery in the Endovascular Treatment of Vascular Diseases: Bystander, Accomplice, Victim, or Friend?

Clip Reconstruction of a Ruptured Thoracic Anterior Spinal Artery Aneurysm Utilizing a Costotransversectomy Approach: 2-Dimensional Operative Video

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