gms | German Medical Science

64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

Article

Send article

Dorsal radiculopial artery aneurysms presenting with spinal subarachnoid hemorrhage. Two cases and a review of the literature.

Meeting Abstract

Search Medline for

  • Martin Ortler - Universitätsklinik für Neurochirurgie, Medizinische Universität Innsbruck, Innsbruck, Österreich
  • Elke Gizewski - Universitätsklinik für Neuroradiologie, Medizinische Universität Innsbruck, Innsbruck, Österreich
  • Hans Maier - Universitätsklinik für Pathologie, Medizinische Universität Innsbruck, Innsbruck, Österreich
  • Claudius Thomé - Universitätsklinik für Neurochirurgie, Medizinische Universität Innsbruck, Innsbruck, Österreich

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocP 063

doi: 10.3205/13dgnc480, urn:nbn:de:0183-13dgnc4805

Published: May 21, 2013

© 2013 Ortler et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: To discuss clinical presentation, imaging characteristics and treatment strategies of symptomatic spinal aneurysms based on the experience of two own cases and data from the literature.

Method: Two patients (case 1, 67yo F, and case 2, 76yo M) presented with symptoms and signs of spinal pathology and underwent diagnostic imaging on an emergency basis (MRI and DSA, case 1; MRI and CTA, case 2). Intradural hemorrhage was demonstrated in both, in case 2 a marked mass effect due to the hemorrhage was evident. DSA showed a spindle shaped aneurysmatic dilatation originating from the rightt radicular artery T11 in case 1 and a pin-shaped contrast accumulation within a large subdural hematoma at C 6 in case 2.

Results: Both patients underwent uneventful microsurgical resection of spindle-shaped aneurysm originating from radiculopial vessels via a limited unilateral dorsal approach. Intraoperative flourescein-angiography demonstrated low flow lesions. Both aneurysms showed a pathologic wall structure with lymphocytic infiltration. Outcome (as of November 30, 2012), was favorable in both patients: Asia scale E (case 1) and D (case 2) after 3 months and 3 weeks respectively.

Conclusions: Literature data suggest that aneurysms originating from the posterior spinal artery are rare (n=9 in a review of the world literature by Geibprasert 2010), are prone to rebleeding and can be cured by resection. Our experience confirms these data.