Background: Spinal aneurysms are rare causes of spontaneous subarachnoid hemorrhage.
Methods: We present an unusual, initially occult, case of an upper thoracic intradural extramedullary isolated aneurysm arising from the T2 intercostal-radicular circulation that was initially angiographically occult but was discovered due to unique, albeit nonspecific, magnetic resonance imaging findings of spinal cord T2 hyperintensity and contrast enhancement that were noted to progress with a clinical picture of ictal rehemorrhage.
Results: Repeat spinal angiography revealed a spinal aneurysm that was treated surgically.
Conclusion: In cases of sufficient clinical suspicion and nonspecific imaging findings, continued vigilance is advised in seeking an underlying pathoanatomic etiology.
Keywords: angiography; neuroradiology; subarachnoid hemorrhage; type II spinal aneurysm.