A cause of atypical intracranial subarachnoid hemorrhage: posterior spinal artery aneurysms

Abstract

Background: Approximately 1 % of cases of intracranial subarachnoid hemorrhage (SAH) are caused by spinal vascular pathologies. Among them, isolated spinal artery aneurysms are uncommon and a limited number of cases have been reported in the literature.

Methods: This is a report of two cases and review of the literature.

Results: Both patients presented with an atypical intracranial SAH and were also found to have spinal SAH caused by a ruptured posterior spinal aneurysm.

Conclusion: Isolated spinal artery aneurysms represent a rare cause of intracranial SAH. Symptoms such as back pain and lower-extremity weakness can be clues to the adequate diagnosis. Surgical or endovascular treatment should be pursued in all patients, as the risk of rebleeding is non-negligible.