Surgical Treatment of Ruptured Aneurysms of Lateral Spinal Artery Presenting as Intracranial Subarachnoid Hemorrhage : Case Series and Literature Review.

IF 1.4 4区 医学 Q4 CLINICAL NEUROLOGY
Journal of Korean Neurosurgical Society Pub Date : 2024-09-01 Epub Date: 2024-06-18 DOI:10.3340/jkns.2024.0040
Yonghun Song, Kwangho Lee, Hyun Park, Soo Hyun Hwang, Hye Jin Baek, In Sung Park
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Abstract

Lateral spinal artery (LSA) aneurysms are extremely rare lesions that can rupture and cause subarachnoid hemorrhage (SAH) even though the spinal arteries communicate directly with the subarachnoid space. To date, six cases of LSA aneurysms have been reported in the literature. Herein, three such cases are reported. All patients presented to the emergency department with headaches. The patients in the first two cases were confirmed to have SAH and LSA aneurysms on a brain computed tomography (CT) angiography performed at the hospital. Two patients had prior instances of cerebral infarction and coronary disease, respectively, and were undergoing antiplatelet therapy. The antiplatelet medication was stopped for 2 weeks and 1 week, respectively, while conservative care was provided. Subsequently, a suboccipital craniectomy was performed, followed by aneurysm clipping. Following the surgery, both patients were discharged without any significant neurological deficits. Regarding the third patient, no aneurysm was found on brain CT angiography, and cerebral angiography was performed during the patient's hospital stay. She was hospitalized, where she received medication and conservative care, and was discharged with an improvement in bleeding without neurological symptoms. Subsequently, a LSA aneurysm was identified on a brain CT angiography performed at an outpatient clinic; however, the patient was transferred because she wanted to be treated at another hospital. LSA aneurysms are difficult to visualize using CT angiography; therefore, careful angiographic studies are required. Surgical clipping is the treatment of choice if the aneurysm is inaccessible by the endovascular treatment.

表现为颅内蛛网膜下腔出血的脊髓侧动脉破裂动脉瘤的手术治疗:病例系列和文献综述。
脊髓侧动脉(LSA)动脉瘤是一种极其罕见的病变,即使脊髓动脉直接与蛛网膜下腔相通,也可能破裂并导致蛛网膜下腔出血(SAH)。迄今为止,已有六例 LSA 动脉瘤的文献报道。(表 1)本文报告了三例此类病例。所有患者均因头痛到急诊科就诊。前两个病例的患者在医院进行的脑计算机断层扫描(CT)血管造影检查证实患有 SAH 和 LSA 动脉瘤。两名患者之前分别患有脑梗塞和冠心病,正在接受抗血小板治疗。在提供保守治疗的同时,分别停止了 2 周和 1 周的抗血小板药物治疗。随后,进行了枕骨下颅骨切除术,接着又进行了动脉瘤剪切术。手术后,两名患者均已出院,没有出现任何明显的神经功能障碍。至于第三位患者,脑部 CT 血管造影未发现动脉瘤,在住院期间进行了脑血管造影。她在住院期间接受了药物治疗和保守护理,出院时出血情况有所改善,但没有出现神经症状。随后,在门诊进行的脑CT血管造影检查中发现了LSA动脉瘤;但患者选择了治疗,并转院至另一家医院。LSA 动脉瘤很难通过 CT 血管造影检查出来,因此需要进行仔细的血管造影检查。如果血管内治疗无法触及动脉瘤,手术切除是首选治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.90
自引率
6.20%
发文量
109
审稿时长
3-8 weeks
期刊介绍: The Journal of Korean Neurosurgical Society (J Korean Neurosurg Soc) is the official journal of the Korean Neurosurgical Society, and published bimonthly (1st day of January, March, May, July, September, and November). It launched in October 31, 1972 with Volume 1 and Number 1. J Korean Neurosurg Soc aims to allow neurosurgeons from around the world to enrich their knowledge of patient management, education, and clinical or experimental research, and hence their professionalism. This journal publishes Laboratory Investigations, Clinical Articles, Review Articles, Case Reports, Technical Notes, and Letters to the Editor. Our field of interest involves clinical neurosurgery (cerebrovascular disease, neuro-oncology, skull base neurosurgery, spine, pediatric neurosurgery, functional neurosurgery, epilepsy, neuro-trauma, and peripheral nerve disease) and laboratory work in neuroscience.
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