title: Successfully Treated Isolated Posterior Spinal Artery Aneurysm Causing Intracranial Subarachnoid Hemorrhage: Case Report.
abstract: There are very few published reports of rupture of an isolated posterior spinal artery (PSA) aneurysm, and consequently the optimal therapeutic strategy is debatable. An 84-year-old man presented with sudden onset of restlessness and disorientation. Neuroradiological imaging showed an intracranial subarachnoid hemorrhage (SAH) with no visible intracranial vascular lesion. Spinal magnetic resonance imaging (MRI) detected a localized subarachnoid hematoma at Th10-11. Both contrast-enhanced spinal computed tomography and enhanced MRI and magnetic resonance angiography revealed an area of enhancement within the hematoma. Superselective angiography of the left Th12 intercostal artery demonstrated a faintly enhanced spot in the venous phase. Thirteen days after the onset of symptoms, a small fusiform aneurysm situated on the radiculopial artery was resected. The patient's postoperative course was uneventful and he was eventually discharged in an ambulatory condition. To our knowledge, this 84-year-old man is the oldest reported case of surgical management of a ruptured isolated PSA aneurysm. This case illustrates both the validity and efficacy of this therapeutic approach.
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Fukuoka University.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Horio
authors.forename: Toshiro
authors.initials: T
authors.lastname: Katsuta
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Samura
authors.forename: Naoki
authors.initials: N
authors.lastname: Wakuta
authors.forename: Kenji
authors.initials: K
authors.lastname: Fukuda
authors.forename: Toshio
authors.initials: T
authors.lastname: Higashi
authors.forename: Tooru
authors.initials: T
authors.lastname: Inoue
mesh_terms: D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D000792:Angiography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014711:Vertebral Artery / Q000000981:diagnostic imaging*