Ruptured posterior spinal artery aneurysm: intraoperative and histologic findings with appreciable thrombosis
Ruptured posterior spinal artery aneurysm: intraoperative and histologic findings with appreciable thrombosis
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DOI：
10.1016/j.spinee.2015.11.015
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发表时间：
2016-03-01
期刊：
影响因子：
4.5
通讯作者：
Kurita, Hiroki
中科院分区：
文献类型：
--
作者：
Ikeda, Shunsuke;Takai, Keisuke;Kurita, Hiroki
背景情况：脊髓动脉瘤破裂的自然过程知之甚少，治疗策略仍有待阐明。目的：本病例报告旨在描述一例罕见的后脊髓动脉瘤，表现为蛛网膜下腔出血后进行性血栓形成。研究设计：这是一份病例报告和文献综述。方法：一名54岁的男性由于T10节段的脊髓后动脉瘤而出现蛛网膜下腔出血。结果：术中吲哚菁绿色血管造影显示大部分动脉瘤无强化，行全切除。组织学检查证实病变自发性血栓形成。文献回顾发现19例脊髓后动脉瘤破裂。在16例接受手术或血管内介入治疗的病例中，7例（44%）观察到动脉瘤血栓形成和载瘤动脉血栓形成。在保守治疗的3例中，在急性期发生致命的再出血1例，而病变在慢性期自发消失，无再出血2 cases.Conclusions：破裂的脊髓动脉瘤容易自发血栓形成。在本病例中，病变的愈合过程得到了很好的记录。重复的血管造影随访为这种相当罕见的动脉瘤的治疗提供了一种可行的替代方法。(C)2016 Elsevier Inc. All rights reserved.
BACKGROUND CONTEXT: Little is known on the natural course of ruptured spinal artery aneurysm, and a treatment strategy remains to be elucidated.PURPOSE: This case report aims to describe a rare case of a posterior spinal artery aneurysm that showed progressive thrombosis following subarachnoid hemorrhage.STUDY DESIGN: 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. (C) 2016 Elsevier Inc. All rights reserved.