Anterior Spinal Artery Steal Syndrome Complicated by Ruptured Flow-Related Aneurysm of the Anterior Radiculomedullary Artery

World Neurosurg. 2020 Dec:144:185-191. doi: 10.1016/j.wneu.2020.08.195. Epub 2020 Sep 2.

Abstract

Background: Anterior spinal artery steal syndrome, radiculomedullary artery aneurysms, and pulmonary arteriovenous malformations with a systemic origin are each, considered individually, exceptional conditions.

Case description: We describe the coexistence of all these conditions and their pathophysiologic relationship by presenting the case of a woman who referred to the emergency department for loss of consciousness and a history of 2 days of medullary symptoms and a subsequent acute respiratory failure. Detailed imaging revealed a subarachnoid hemorrhage due to the rupture of a spinal aneurysm located in a C8 radiculomedullary artery that had its flow reversed toward the deep cervical artery from which a systemic to pulmonary arteriovenous malformation originated.

Conclusions: Eventually, the lesion was treated with the exclusion of the left C8 spinal segmental branch and embolization of the arteriovenous malformation.

Keywords: Anterior spinal artery steal; Flow related aneurysm; SP-AVMs; Spinal SAH.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aneurysm, Ruptured / complications*
  • Aneurysm, Ruptured / surgery*
  • Angiography, Digital Subtraction
  • Arteries / surgery*
  • Arteriovenous Malformations / complications
  • Arteriovenous Malformations / surgery
  • Cerebral Arteries / surgery*
  • Embolization, Therapeutic
  • Female
  • Humans
  • Neuroimaging
  • Pulmonary Disease, Chronic Obstructive / complications
  • Spine / blood supply
  • Spine / surgery*
  • Subarachnoid Hemorrhage / complications*
  • Subarachnoid Hemorrhage / surgery*
  • Tomography, X-Ray Computed
  • Treatment Outcome