title: Isolated spinal artery aneurysm: a rare culprit of subarachnoid haemorrhage.
abstract: Isolated spinal artery aneurysm is a rare lesion which could be accountable for spontaneous spinal subarachnoid haemorrhage. We describe the case of a 74-year-old man presenting with sudden onset of chest pain radiating to the neck and back, with subsequent headache and confusion. Initial computed tomography aortogram revealed incidental finding of subtle acute spinal subarachnoid haemorrhage. A set of computed tomography scans of the brain showed further acute intracranial subarachnoid haemorrhage with posterior predominance, small amount of intraventricular haemorrhage, and absence of intracranial vascular lesions. Subsequent magnetic resonance imaging demonstrated a thrombosed intradural spinal aneurysm with surrounding sentinel clot, which was trapped and excised during surgical exploration. High level of clinical alertness is required in order not to miss this rare but detrimental entity. Its relevant aetiopathological features and implications for clinical management are discussed.
authors.affiliation: Department of Radiology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors.forename: Tony H T
authors.initials: TH
authors.lastname: Sung
authors.affiliation: Department of Radiology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors.forename: Warren K W
authors.initials: WK
authors.lastname: Leung
authors.affiliation: Department of Radiology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors.forename: Bill M H
authors.initials: BM
authors.lastname: Lai
authors.affiliation: Department of Radiology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors.forename: Jennifer L S
authors.initials: JL
authors.lastname: Khoo
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology; D004636:Emergency Service, Hospital; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D035583:Rare Diseases; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods; D014711:Vertebral Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology
keywords: Aneurysm; Spinal cord; Subarachnoid hemorrhage