Kawai Nobuhiko, Tatano Masaki, Imoto Ryoji, Hirashita Koji, Yunoki Masatoshi, Yoshino Kimihiro
Department of Neurosurgery, Kagawa Rosai Hospital, Marugame, Kagawa, Japan.
NMC Case Rep J. 2021 Jul 3;8(1):331-334. doi: 10.2176/nmccrj.cr.2020-0178. eCollection 2021.
Anterior spinal artery (ASA) aneurysms are rare, and the majority are associated with vascular lesions such as arteriovenous malformations, moyamoya disease, and aortic stenosis. Herein, we report a case of a ruptured anterior spinal artery aneurysm caused by bilateral vertebral artery (VA) occlusion, which was treated by coil embolization. An 83-year-old man was found collapsed at home, and was brought in by emergency. His consciousness level was I-1 on the Japan Coma Scale, and there were no symptoms such as paralysis in the extremities. Computed tomography showed Fisher 3 subarachnoid hemorrhage, while magnetic resonance angiography showed an aneurysm in the right VA. Digital subtraction angiography showed bilateral VA occlusion, and an aneurysm was found on the dilated ASA as a collateral circulation. Coil embolization was performed after confirmation of no hemodynamic problems. No postoperative adverse events were observed. Coil embolization may be an effective treatment for ruptured aneurysms of the ASA.
脊髓前动脉（ASA）动脉瘤较为罕见，大多数与动静脉畸形、烟雾病和主动脉狭窄等血管病变相关。在此，我们报告一例由双侧椎动脉（VA）闭塞导致的脊髓前动脉动脉瘤破裂病例，该病例通过弹簧圈栓塞进行治疗。一名83岁男性在家中被发现晕倒，由急救人员送来。其日本昏迷量表意识水平为I-1级，四肢无瘫痪等症状。计算机断层扫描显示Fisher 3级蛛网膜下腔出血，而磁共振血管造影显示右侧椎动脉有一个动脉瘤。数字减影血管造影显示双侧椎动脉闭塞，在扩张的脊髓前动脉作为侧支循环处发现一个动脉瘤。在确认无血流动力学问题后进行了弹簧圈栓塞。术后未观察到不良事件。弹簧圈栓塞可能是治疗脊髓前动脉破裂动脉瘤的有效方法。
