title: Ruptured posterior spinal artery aneurysm: intraoperative and histologic findings with appreciable thrombosis.
abstract: BACKGROUND
  Little is known on the natural course of ruptured spinal artery aneurysm, and a treatment strategy remains to be elucidated.
  
  
  OBJECTIVE
  This case report aims to describe a rare case of a posterior spinal artery aneurysm that showed progressive thrombosis following subarachnoid hemorrhage.
  
  
  METHODS
  This is a case report and literature review.
  
  
  METHODS
  A 54-year-old man presented with subarachnoid hemorrhage due to posterior spinal artery aneurysm at the T10 level. The patient underwent surgery 19 days after onset.
  
  
  RESULTS
  Most of the aneurysm appeared unenhanced on intraoperative indocyanine green video angiography, and total resection was performed. Histologic examination confirmed spontaneous thrombosis of the lesion. A review of the literature identified 19 cases of ruptured posterior spinal artery aneurysm. Thrombosed aneurysm and thrombosed parent artery were observed in 7 (44%) of the 16 cases treated with surgical or endovascular interventions. In the three cases treated conservatively, fatal rebleeding in the acute stage was noted in one case, whereas the lesion disappeared spontaneously in the chronic stage without rebleeding in two cases.
  
  
  CONCLUSIONS
  Ruptured spinal artery aneurysms are prone to spontaneous thrombosis. The healing process of the lesion was well documented in the present case. Repeated angiographic follow-up offers a feasible alternative in the management of this fairly rare aneurysm.
authors.affiliation: Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Ikeda
authors.affiliation: Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, 2-6-1, Musashidai, Fuchu, Tokyo 183-0042, Japan. Electronic address: takai-nsu@umin.ac.jp.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Takai
authors.affiliation: Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Kikkawa
authors.affiliation: Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.
authors.forename: Ririko
authors.initials: R
authors.lastname: Takeda
authors.affiliation: Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Ikeda
authors.affiliation: Department of Intravascular Neurosurgery, International Medical Center, Saitama Medical University, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Kohyama
authors.affiliation: Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kurita
mesh_terms: D017542:Aneurysm, Ruptured / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D000792:Angiography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013116:Spinal Cord / Q000098:blood supply* / Q000000981:diagnostic imaging; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery