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Case Reports
. 2019 Dec;29(4):777-781.
doi: 10.1007/s00062-019-00772-6. Epub 2019 Mar 14.

Spontaneous Cervical Intramedullary and Subarachnoid Hemorrhage due to a Sulco-Commissural Artery Aneurysm

E Donauer  1 , M Aguilar Pérez  2 , N Jangid  1 , B Tomandl  3 , O Ganslandt  4 , H Henkes  5   6
Affiliations
Case Reports

Spontaneous Cervical Intramedullary and Subarachnoid Hemorrhage due to a Sulco-Commissural Artery Aneurysm

E Donauer et al. Clin Neuroradiol. 2019 Dec.
No abstract available

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Conflict of interest statement

E. Donauer, M. Aguilar Pérez, N. Jangid, B. Tomandl, O. Ganslandt and H. Henkes have no conflict of interest in the context of the presented case report. H. Henkes is co-founder and shareholder of phenox GmbH and femtos GmbH. M. Aguilar Pérez has a proctoring and consulting agreement with phenox GmbH.

Figures

Fig. 1
Fig. 1
Diagnostic imaging and treatment in a patient with cervical hematomyelia due to an aneurysm of a sulco-commissural artery, associated with a cervical intradural arteriovenous fistula. T2*weighted image showing the hematoma in the cervical spinal cord and the surrounding edema (a). DSA at this time revealed an intradural arteriovenous fistula with dominant radiculomeningeal supply via the right VA (b). Injection of the left vertebral artery shows the pial supply of the intradural arteriovenous fistula via the anterior spinal artery (c). Selective injection of the anterior spinal artery 5 months later shows the connection between the anterior spinal artery and the aneurysm via a sulco-commissural artery (d). Meanwhile the aneurysm had considerably increased. While the guidewire could be introduced into the sulco-commissural artery, the vessel’s small caliber did not allow passage of the microcatheter (e). Via a small microsurgical approach to the cervical spinal cord from the right side and after dissection of the spinal cord tissue, the wall of the aneurysm became visible (f). Thermocoagulation of the wall of the aneurysm resulted in shrinkage of the lesion, providing additional space for further dissection of the whole aneurysm. After mobilization of the aneurysm, the afferent sulco-commissural artery was identified and the borders of the adjacent spinal cord were visible. The feeding artery was divided with microscissors. Postoperative follow-up MRI on the first day after the microsurgical aneurysm resection shows the hemosiderin remnants (T2-weighted image g) while the previous contrast enhancing aneurysm wall is no longer visible on contrast enhanced T1WI (h). DSA of the right (i) and left (j) vertebral artery 3 weeks after the microsurgical resection of the sulco-commissural artery aneurysm. The previous aneurysm is no longer visible, the continuity of the anterior spinal artery is preserved and a small remnant of the intradural AV-fistula remains perfused
See this image and copyright information in PMC

References

    1. Vincent FM. Anterior spinal artery aneurysm presenting as a subarachnoid hemorrhage. Stroke. 1981;12(2):230–232. doi: 10.1161/01.STR.12.2.230. - DOI - PubMed
    1. Yang TK. A ruptured aneurysm in the branch of the anterior spinal artery. J Cerebrovasc Endovasc Neurosurg. 2013;15(1):26–29. doi: 10.7461/jcen.2013.15.1.26. - DOI - PMC - PubMed
    1. Pahl FH, de Oliveira MF, Rotta MA, Dias GM, Rezende AL, Rotta JM. Spontaneous resolution of an isolated cervical anterior spinal artery aneurysm after subarachnoid hemorrhage. Surg Neurol Int. 2014;25(5):139. - PMC - PubMed
    1. Dabus G, Tosello RT, Pereira BJA, Linfante I, Piske RL. Dissecting spinal aneurysms: conservative management as a therapeutic option. J Neurointerv Surg. 2018;10(5):451–454. doi: 10.1136/neurintsurg-2017-013566. - DOI - PubMed
    1. Nakhla J, Nasser R, Yassari R, Pasquale D, Altschul D. Ruptured anterior spinal artery aneurysm from a herniated cervical disc. A case report and review of the literature. Surg Neurol Int. 2016;28(7):10. doi: 10.4103/2152-7806.175072. - DOI - PMC - PubMed

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