title: Dissection aneurysm of the radiculomedullary branch of the artery of Adamkiewicz with subarachnoid hemorrhage.
abstract: A 60-year-old female presented with sudden onset of severe headache and back pain, followed by nausea. The initial head computed tomography (CT) scan revealed posterior fossa subarachnoid hemorrhage (SAH). Spinal T(2)-weighted magnetic resonance imaging demonstrated SAH, and a homogeneous and slightly low signal intensity mass at T11. Spinal angiography in the early arterial phase revealed a small pearl and string-like aneurysm of the proximal radiculomedullary artery on the left side at the T12 level. Forty days after the onset of SAH, CT angiography demonstrated complete occlusion of the dissecting aneurysm and the preserved anterior spinal artery. The present case of ruptured dissecting aneurysm of the radiculomedullary branch of the artery of Adamkiewicz with SAH underwent subsequent spontaneous occlusion, indicating that the wait-and-see strategy may be justified and will provide adequate treatment.
authors.affiliation: Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan. iiboshi@sapmed.ac.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iihoshi
authors.forename: Kei
authors.initials: K
authors.lastname: Miyata
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Murakami
authors.forename: Takahisa
authors.initials: T
authors.lastname: Kaneko
authors.forename: Izumi
authors.initials: I
authors.lastname: Koyanagi
mesh_terms: D000784:Aortic Dissection / Q000150:complications / Q000473:pathology*; D017542:Aneurysm, Ruptured / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D001012:Aorta, Abdominal / Q000503:physiopathology; D001158:Arteries / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020127:Recovery of Function / Q000502:physiology; D013116:Spinal Cord / Q000098:blood supply*; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D013904:Thoracic Vertebrae / Q000098:blood supply; D014057:Tomography, X-Ray Computed