Isolated cervical anterior spinal artery aneurysm: case report

Area of Science:

• Neuroscience
• Vascular Neurology
• Spinal Cord Medicine

Background:

• Cervical anterior spinal artery (CASA) aneurysms are exceptionally rare vascular lesions.
• Most reported CASA aneurysms are associated with arteriovenous malformations, with unclear underlying pathology.
• Potential contributing factors include inflammatory conditions, infections, connective tissue disorders, and trauma-induced pseudoaneurysms.

Observation:

• A rare case of an isolated cervical anterior spinal artery aneurysm presented with a fourth ventricle hemorrhage.
• The patient's condition involved a significant intracranial bleed originating from the spinal vasculature.
• This presentation is atypical given the usual association of CASA aneurysms with arteriovenous malformations.

Findings:

• The patient with a fourth ventricle bleed due to a CASA aneurysm was successfully managed conservatively.
• Non-surgical intervention proved effective in resolving the acute hemorrhage and stabilizing the patient.
• This case challenges the typical surgical approach for spinal vascular lesions presenting with intracranial hemorrhage.

Implications:

• Conservative management may be a viable option for select cases of CASA aneurysms presenting with intracranial bleeding.
• Further research is needed to elucidate the specific etiologies and optimal treatment strategies for these rare aneurysms.
• This case expands the understanding of potential clinical presentations and management outcomes for cervical anterior spinal artery aneurysms.