Skip to main content
  • Isolated Intradural Nontraumatic Adamkeiwicz Aneurysm

    Final Number:

    Cody Doberstein; John F. Morrison MD; Brian Silver MD; Andrew Bouley MD; Mahesh V Jayaraman MD

    Study Design:

    Subject Category:
    Vascular Malformations

    Meeting: AANS/CNS Cerebrovascular Section 2016 Annual Meeting

    Introduction: Spinal vascular lesions have historically been classified in to three broad categories, neoplastic, aneurysmal, and arteriovenous malformations. Further subclassification of spinal artery aneurysm lesions refer to their relation to the dura matter e.g. extra- and intra- dural. Spontaneous lesions of the Artery of Adamkiewicz remain rare and, therefore, optimal treatment modality is unclear. We present one such case, managed conservatively with clinical observation. Likewise, we review the history of treatment and discuss the risks and benefits of each modality.

    Methods: This study is a retrospective chart review. Due to the elevated procedural risk associated with treatment, it was elected to follow the patient with clinical observation. We present the illustrative case and a review of the literature.

    Results: The patient declined to have follow-up angiogram after discharge. He has recovered completely, and has only mild baseline tremor consistent with his known Parkinson’s disease.

    Conclusions: Conservative management of spinal artery of Adamkeiwicz is a safe and effective approach to this rare disorder.

    Patient Care: Understanding pathophysiology and management options aids in decision making.

    Learning Objectives: Management of non-traumatic spinal artery aneurysms

    References: Alleyne CH, Jr., Cawley CM, Shengelaia GG, Barrow DL: Microsurgical anatomy of the artery of Adamkiewicz and its segmental artery. J Neurosurg 89:791-795, 1998 Atlas SW: Magnetic Resonance Imaging of the Brain and Spine: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2009 Berlis A, Scheufler K-M, Schmahl C, Rauer S, Götz F, Schumacher M: Solitary Spinal Artery Aneurysms as a Rare Source of Spinal Subarachnoid Hemorrhage: Potential Etiology and Treatment Strategy. American Journal of Neuroradiology 26:405-410, 2005 Garcia CA, Dulcey S, Dulcey J: Ruptured aneurysm of the spinal artery of Adamkiewicz during pregnancy. Neurology 29:394-398, 1979 Iihoshi S, Miyata K, Murakami T, Kaneko T, Koyanagi I: Dissection aneurysm of the radiculomedullary branch of the artery of Adamkiewicz with subarachnoid hemorrhage. Neurol Med Chir (Tokyo) 51:649-652, 2011 Massand MG, Wallace RC, Gonzalez LF, Zabramski JM, Spetzler RF: Subarachnoid Hemorrhage Due to Isolated Spinal Artery Aneurysm in Four Patients. American Journal of Neuroradiology 26:2415-2419, 2005 Moore KL, Agur AMR: Essential Clinical Anatomy: Lippincott Williams & Wilkins, 2007 Son S, Lee SG, Park CW: Solitary ruptured aneurysm of the spinal artery of adamkiewicz with subarachnoid hemorrhage. J Korean Neurosurg Soc 54:50-53, 2013 Spetzler RF, Detwiler PW, Riina HA, Porter RW: Modified classification of spinal cord vascular lesions. J Neurosurg 96:145-156, 2002 Vishteh AG, Brown AP, Spetzler RF: Aneurysm of the intradural artery of Adamkiewicz treated with muslin wrapping: technical case report. Neurosurgery 40:207-209, 1997 Wan IY, Angelini GD, Bryan AJ, Ryder I, Underwood MJ: Prevention of spinal cord ischaemia during descending thoracic and thoracoabdominal aortic surgery. Eur J Cardiothorac Surg 19:203-213, 2001 Yoshioka K, Niinuma H, Ohira A, Nasu K, Kawakami T, Sasaki M, et al: MR angiography and CT angiography of the artery of Adamkiewicz: noninvasive preoperative assessment of thoracoabdominal aortic aneurysm. Radiographics 23:1215-1225, 2003

We use cookies to improve the performance of our site, to analyze the traffic to our site, and to personalize your experience of the site. You can control cookies through your browser settings. Please find more information on the cookies used on our site. Privacy Policy