Artikel
Dorsal radiculopial artery aneurysms presenting with spinal subarachnoid hemorrhage. Two cases and a review of the literature.
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Autoren
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Martin Ortler
- Universitätsklinik für Neurochirurgie, Medizinische Universität Innsbruck, Innsbruck, Österreich
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Elke Gizewski
- Universitätsklinik für Neuroradiologie, Medizinische Universität Innsbruck, Innsbruck, Österreich
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Hans Maier
- Universitätsklinik für Pathologie, Medizinische Universität Innsbruck, Innsbruck, Österreich
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Claudius Thomé
- Universitätsklinik für Neurochirurgie, Medizinische Universität Innsbruck, Innsbruck, Österreich
| Veröffentlicht: | 21. Mai 2013 |
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Gliederung
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Objective: To discuss clinical presentation, imaging characteristics and treatment strategies of symptomatic spinal aneurysms based on the experience of two own cases and data from the literature.
Method: Two patients (case 1, 67yo F, and case 2, 76yo M) presented with symptoms and signs of spinal pathology and underwent diagnostic imaging on an emergency basis (MRI and DSA, case 1; MRI and CTA, case 2). Intradural hemorrhage was demonstrated in both, in case 2 a marked mass effect due to the hemorrhage was evident. DSA showed a spindle shaped aneurysmatic dilatation originating from the rightt radicular artery T11 in case 1 and a pin-shaped contrast accumulation within a large subdural hematoma at C 6 in case 2.
Results: Both patients underwent uneventful microsurgical resection of spindle-shaped aneurysm originating from radiculopial vessels via a limited unilateral dorsal approach. Intraoperative flourescein-angiography demonstrated low flow lesions. Both aneurysms showed a pathologic wall structure with lymphocytic infiltration. Outcome (as of November 30, 2012), was favorable in both patients: Asia scale E (case 1) and D (case 2) after 3 months and 3 weeks respectively.
Conclusions: Literature data suggest that aneurysms originating from the posterior spinal artery are rare (n=9 in a review of the world literature by Geibprasert 2010), are prone to rebleeding and can be cured by resection. Our experience confirms these data.
