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Pierluigi Longatti, Donatella Sgubin, and Francesco Di Paola

S ubarachnoid hemorrhage due to spinal vessel lesions is infrequently encountered in clinical practice, and the most common cause is bleeding from a spinal cord AVM or an intraspinal tumor. 1 Spinal SAH due to the rupture of spinal artery aneurysms is extremely rare ( Table 1 ). 21 , 25 In the present paper we report a case of acute spinal SAH due to the rupture of multiple aneurysms of the anterior spinal artery and review the relevant literature. TABLE 1 Reported cases of spinal artery aneurysms * Authors & Year

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Alexis Victorien Konan, Jean Raymond, and Daniel Roy

S pinal cord arteriovenous malformations (SCAVMs) are most challenging neurovascular lesions. 2, 6, 8–10, 14, 15, 20, 21, 25, 26 The natural history of patients with SCAVMs is poor 1, 2, 6, 13–15, 20, 25, 26, 29 and the risks of surgical or endovascular treatment of lesions involving the anterior spinal artery (ASA) are sometimes prohibitive. 1, 2, 6, 13–15, 20, 25, 26, 29 Aneurysms associated with SCAVMs have been reported as risk factors for hemorrhage. 4, 7, 25 There may be a role for partial treatment of incurable arteriovenous malformations (AVMs) if

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Pascale Lavoie, Jean Raymond, Daniel Roy, François Guilbert, and Alain Weill

I n 1967, Di Chiro and colleagues 5 first explored spinal vascular malformations using selective angiography. Since then, as a result of the escalating development of endovascular technology and microsurgery, our comprehension and handling of spinal cord AVMs have notably improved. Nonetheless, the treatment of this rare entity remains hazardous. Most authors, however, agree that associated arterial aneurysms, especially when accounting for spinal SAH, should be targeted as a priority. 9 , 11 , 17 Because of the tenuous blood supply of the ASA and its

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Hisashi Kubota, Ehichi Suehiro, Hiroshi Yoneda, Sadahiro Nomura, Koji Kajiwara, Masami Fujii, Hirosuke Fujisawa, Shoichi Kato, and Michiyasu Suzuki

Spinal artery aneurysms are rare in intracranial lesions, and lateral spinal artery (LSA) aneurysms have been reported in only two cases. 1 We describe the first case of an LSA aneurysm developing after posterior inferior cerebellar artery (PICA) occlusion. This 59-year-old woman was admitted to our hospital with sudden-onset severe headache and consciousness disturbance. A computerized tomography (CT) study revealed subarachnoid hemorrhage (SAH) in the posterior fossa, mostly around the medulla oblongata. Initial and subsequent angiographic studies

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Cary D. Alberstone, Frederick W. Rupp, and John A. Anson

S pinal aneurysms are uncommon lesions, the diagnosis of which is frequently missed at presentation. 7, 10, 11, 14 Despite their rarity, however, failure to consider these lesions in the differential diagnosis of an extramedullary spinal mass could result in a surgical misadventure. Most spinal aneurysms are associated with an AVM. 1, 5, 8–10, 13, 16 It is believed that the high-flow state associated with AVMs causes aneurysms to develop in feeding vessels. 13 In this report, we present the case of a spinal aneurysm, unrelated to an AVM, that produced a

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Venkatesh S. Madhugiri, Sudheer Ambekar, V. R. Roopesh Kumar, Gopalakrishnan M. Sasidharan, and Anil Nanda

papers were then read, and those that met the inclusion criteria were listed for data extraction. If an abstract had not been provided, the paper directly entered the stage of full-text reading (if selected on the basis of the title). There were major variations in the terminology used to describe spinal vascular lesions, especially in papers published prior to 1990 (spinal angioma, arteriovenous aneurysm, and so on). In these instances, the angiograms provided in the case reports were reviewed to assess the suitability of the lesion for inclusion in the final analysis

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Robert F. Spetzler, Paul W. Detwiler, Howard A. Riina, and Randall W. Porter

( Table 2 ): neoplasms, aneurysms, and arteriovenous lesions. Arteriovenous lesions are further subdivided based on their neuroanatomy. This classification system eliminates the confusion inherent in previous classification systems and can be used to determine the appropriate surgical treatment. TABLE 1 Old nomenclature for spinal cord vascular lesion angioma arteriovenosum angioma cavernosum angioma racemosum angioma racemosum arteriovenosum angioma racemosum venosum angioreticuloma classic AVM dorsal

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Toshinori Sakai, Shinsuke Katoh, Koichi Sairyo, Kosaku Higashino, Nori Hirohashi, and Natsuo Yasui

are completely eroded by what appears to be a predominantly pre-vertebral mass exhibiting enhancement. F ig . 4. A 99m Tc–methylene diphosphonate bone scan revealing increased uptake at the L4–5 level. F ig . 5. Abdominal contrast-enhanced CT scans revealing the contained rupture of an AAA invading the L4–5 intervertebral disc with destruction of the endplates of the VBs. Operation Using a transabdominal approach, the cardiovascular surgeons removed the aneurysm and reconstructed the abominal aorta using an artificial vascular graft

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Shingo Toyota, Akatsuki Wakayama, Yasunori Fujimoto, Shiro Sugiura, and Toshiki Yoshimine

T he atlantoaxial articulation in rheumatoid arthritis is prone to subluxation. 3 , 8 In AAS, the arteries, including the VA, are in danger of being stretched, kinked, or compressed, but it has not been reported to cause SAH. We present a rare case of SAH due to a dissecting aneurysm of the radiculomedullary artery that originated from an extracranial VA dissection with AAS. Case Report History and Presentation This 65-year-old woman presented with a 32-year history of erosive rheumatoid arthritis. She had been treated medically with

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Erich G. Anderer, Matthew M. Kang, Yaron A. Moshel, and Anthony Frempong-Boadu

E xposure for the surgical treatment of spinal AVMs has largely consisted of laminectomy and other posterior techniques. In this paper we present the case of a Type IV AVM with 2 associated aneurysms treated using an anterior approach. Illustrative Case This 47-year-old man with a history of hypertension presented to a different hospital with acute onset of low-back pain, bilateral lower extremity weakness, and urinary incontinence. A magnetic resonance image revealed an intradural hematoma with flow voids at the T-11 vertebral level ( Fig. 1 ). Upon