Unruptured aneurysm of the anterior spinal artery presenting as paraparesis

Case report

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✓ A case is presented in which spinal cord compression was caused by an unruptured aneurysm of the anterior spinal artery. The nature of the mass was not disclosed until it was surgically exposed. Resection of the sac was followed by neurological recovery.

Article Information

Address reprint requests to: B. A. R. Stokes, M.B., B.S., F.R.A.C.S., Department of Neurosurgery, Royal Perth Hospital, Perth 6000, Western Australia.

© AANS, except where prohibited by US copyright law.

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    Left: Myelogram (prone view) shows an extrinsic intrathecal mass level with the lower half of the body of T-7. The cord is displaced to the right. The mass was not seen to pulsate on fluoroscopy. Right: Myelogram (lateral projection, right side down) shows the cord displaced posteriorly by the mass which has a lobulated upper margin. Enlarged vessels (arrows) are seen beneath the mass.

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    Left: Selective intercostal spinal arteriogram (subtraction print). The right ninth intercostal artery is catheterized (open arrow). The radiculomedullary branch (artery of Adamkiewicz) can be seen (curved arrow) ascending to supply the anterior spinal artery, which is descending anterior to the cord (small straight arrows). Metallic clips mark the site of aneurysm excision (large straight arrow). Right: Intercostal arteriogram at the site of aneurysm excision (subtraction print). The catheter (open arrow) is in the eighth intercostal artery (middle arrow). An enlarged radiculomedullary branch can be seen (upper arrow) terminating abruptly at the operative site.

References

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