Scholarlink

Purpose <p>To share our clinical experience with conservative management of isolated spinal arterial aneurysms (ISAs) and to identify clinical scenarios where conservative management may be appropriate, in the context of a literature review.</p> Methods <p>We performed a retrospective review of spinal angiograms from two German neuroradiology centers and conducted a systematic literature review of reported ISA cases. We analyzed demographics, clinical presentation, imaging findings, treatments, and outcomes.</p> Results <p>We identified seven patients (mean age 48; 4 women) with nine ISAs, eight of which were managed conservatively. Five of them had excellent short-term outcomes, and spontaneous regression was documented in four cases. With our cases, 208 ISAs have been reported in the literature in 164 patients (mean age 51; 52% female). They most commonly present with subarachnoid hemorrhage (90%) and back pain (69%). Most are located in the thoracic (51%) or cervical spine (40%) and involve the anterior spinal circulation (63%). They may be treated by surgical intervention (47%) or conservatively (37%), less commonly by endovascular therapy (16%). 78% of patients have favorable outcomes (mRS 0–3), similar across all treatment approaches. In 52% of conservatively managed cases, spontaneous regression was documented by imaging. Clinical deterioration was primarily associated with respiratory complications and spinal cord infarction, with a documented rebleeding rate of 8% and a mortality rate of 12%.</p> Conclusions <p>ISAs are a rare and potentially underrecognized cause of cerebral and spinal subarachnoid hemorrhage. In select cases, particularly small ISAs of the anterior spinal or a radiculomedullary artery and with transient neurological symptoms, conservative management appears to be a reasonable approach, supported by increasing evidence of the possibility of spontaneous regression.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Isolated spinal aneurysms with spontaneous regression

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年9月8日

查看全文
  • Vivien Richter,
  • Ali Khanafer,
  • Sven Poli,
  • Alexandra Gómez Expósito,
  • Patrick Haas,
  • Constantin Roder,
  • Ulrike Ernemann,
  • Hans Henkes,
  • Florian Hennersdorf

摘要

Purpose

To share our clinical experience with conservative management of isolated spinal arterial aneurysms (ISAs) and to identify clinical scenarios where conservative management may be appropriate, in the context of a literature review.

Methods

We performed a retrospective review of spinal angiograms from two German neuroradiology centers and conducted a systematic literature review of reported ISA cases. We analyzed demographics, clinical presentation, imaging findings, treatments, and outcomes.

Results

We identified seven patients (mean age 48; 4 women) with nine ISAs, eight of which were managed conservatively. Five of them had excellent short-term outcomes, and spontaneous regression was documented in four cases. With our cases, 208 ISAs have been reported in the literature in 164 patients (mean age 51; 52% female). They most commonly present with subarachnoid hemorrhage (90%) and back pain (69%). Most are located in the thoracic (51%) or cervical spine (40%) and involve the anterior spinal circulation (63%). They may be treated by surgical intervention (47%) or conservatively (37%), less commonly by endovascular therapy (16%). 78% of patients have favorable outcomes (mRS 0–3), similar across all treatment approaches. In 52% of conservatively managed cases, spontaneous regression was documented by imaging. Clinical deterioration was primarily associated with respiratory complications and spinal cord infarction, with a documented rebleeding rate of 8% and a mortality rate of 12%.

Conclusions

ISAs are a rare and potentially underrecognized cause of cerebral and spinal subarachnoid hemorrhage. In select cases, particularly small ISAs of the anterior spinal or a radiculomedullary artery and with transient neurological symptoms, conservative management appears to be a reasonable approach, supported by increasing evidence of the possibility of spontaneous regression.