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Case Reports
. 2014 Sep 25:5:139.
doi: 10.4103/2152-7806.141776. eCollection 2014.

Spontaneous resolution of an isolated cervical anterior spinal artery aneurysm after subarachnoid hemorrhage

Felix Hendrik Pahl  1 , Matheus Fernandes de Oliveira  1 , Marcus Alexandre Cavalcanti Rotta  1 , Guilherme Marcos Soares Dias  1 , André Luiz Rezende  1 , José Marcus Rotta  1
Affiliations
Case Reports

Spontaneous resolution of an isolated cervical anterior spinal artery aneurysm after subarachnoid hemorrhage

Felix Hendrik Pahl et al. Surg Neurol Int. .

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.

Keywords: Diagnosis; intracranial aneurysm; treatment.

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Figures

Figure 1
Figure 1
Skull CT revealing SAH in basal cisterns, hydrocephalus and hemoventricle in posterior fossa; brain MR disclosing laminar hemorrhage in T1 sagittal and axial images, just ahead of cervicomedullary junction; cerebral angiogram: In A, anteroposterior view of posterior circulation with no abnormalities. In B, lateral view. In C, a small aneurysm in ASA is noted, which is better exposed in D
Figure 2
Figure 2
An angiotomography of intracranial vessels, which could not identify the ASA aneurysm
Figure 3
Figure 3
Amplified image of ASA aneurysm at diagnosis, with 2 mm of diameter. At right, control angiogram 3 months after bleeding, revealing normal posterior circulation
See this image and copyright information in PMC

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