Spontaneous thrombosis with a conservative approach to posterior spinal artery pseudoaneurysm management: A case series.
Autor: | Pirahanchi Y; Department of Neurology, Swedish Medical Center, Englewood, CO, USA., Atchie B; Department of Neurology, Swedish Medical Center, Englewood, CO, USA., Flynn M; Department of Neurology, Swedish Medical Center, Englewood, CO, USA., Kaminsky I; Department of Neurology, Swedish Medical Center, Englewood, CO, USA. |
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Jazyk: | angličtina |
Zdroj: | Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences [Interv Neuroradiol] 2024 May 07, pp. 15910199241249779. Date of Electronic Publication: 2024 May 07. |
DOI: | 10.1177/15910199241249779 |
Abstrakt: | In this study, we address the rarity and management challenges associated with ruptured spinal artery pseudoaneurysms, which comprise < 1% of subarachnoid hemorrhage cases. With our limited understanding of their natural history, the prevailing consensus leans towards surgical clipping, contrasting with the typically benign symptoms of sudden back pain and lower extremity weakness. Despite reported low morbidity and mortality, fatal re-ruptures underscore the need for effective management strategies. In this context, we present the largest case series to date, featuring five patients with spinal subarachnoid hemorrhage from isolated posterior spinal artery pseudoaneurysms. All cases achieved spontaneous thrombosis and resolution through conservative management, challenging the prevailing surgical emphasis. The patients, aged 58-81, exhibited varied symptoms, including back pain, paresthesia, confusion, and seizures, with hypertension as a common comorbidity. The results of these cases lead us to tender a "hybrid" management strategy, combining conservative measures with short-term follow-up angiograms, fostering a paradigm shift and warranting further investigation into individualized patient care within larger clinical cohorts. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
Databáze: | MEDLINE |
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