title: Lateral sacral artery aneurysm of the lumbar spine: hemorrhage resulting in cauda equina syndrome.
abstract: OBJECTIVE
  To describe the effective treatment of a ruptured lateral sacral artery aneurysm presenting as a spinal epidural hematoma.
  
  
  METHODS
  Case report and literature review.
  
  
  METHODS
  University teaching hospital, neurovascular center.
  
  
  METHODS
  A man with a history of renal allograft who presented with sudden onset low back pain.
  
  
  METHODS
  The patient underwent emergent decompressive surgery, diagnostic angiogram and endovascular embolization.
  
  
  METHODS
  Obliteration of aneurysm and restoration of neurological function.
  
  
  RESULTS
  Surgery resulted in decompression of the cauda equina. The patient's aneurysm was endovascularly obliterated. There was complete restoration of neurological function.
  
  
  CONCLUSIONS
  Lateral sacral artery aneurysm formation and rupture is a rare cause of epidural hemorrhage and one described only in patients who have undergone renal transplantation. It may be caused by high flow from transpelvic collaterals between both internal iliac arteries. Treatment includes endovascular obliteration and may necessitate operative decompression in the setting of neurological compromise.
authors: Division of Interventional Neuroradiology and Endovascular Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
authors: Raul G
authors: RG
authors: Nogueira
authors: Ekkehard
authors: E
authors: Kasper
authors: Brian P
authors: BP
authors: Walcott
authors: Brian V
authors: BV
authors: Nahed
authors: Navid
authors: N
authors: Redjal
authors: Jean-Valery
authors: JV
authors: Coumans
authors: Joshua A
authors: JA
authors: Hirsch
mesh_terms: D000783:Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D004621:Embolization, Therapeutic; D046748:Hematoma, Epidural, Spinal / Q000150:complications / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D011128:Polyradiculopathy / Q000209:etiology*; D012447:Sacrum / Q000098:blood supply*; D013116:Spinal Cord / Q000098:blood supply* / Q000473:pathology