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

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