Dissecting spinal aneurysms: conservative management as a therapeutic option

Area of Science:

• Neurosurgery
• Vascular Neurology
• Interventional Neuroradiology

Background:

• Dissecting spinal aneurysms are uncommon vascular lesions.
• Their management presents a therapeutic challenge due to rarity.

Purpose of the Study:

• To report the management experience of four patients with dissecting spinal aneurysms.
• To evaluate the efficacy of conservative management for these rare aneurysms.

Main Methods:

• Retrospective review of neurointerventional databases from two institutions.
• Inclusion criteria focused on spinal dissecting aneurysms in spinal arteries or radiculomedullary arteries, excluding flow-related aneurysms.
• Data collected included clinical presentation, hemorrhage, aneurysm characteristics, follow-up, and outcomes.

Main Results:

• Four patients with five spinal dissecting aneurysms were identified.
• All patients presented with hemorrhage and were managed conservatively.
• Follow-up angiography showed complete occlusion of all aneurysms with no re-hemorrhage and good clinical outcomes (modified Rankin Scale score 0-2).

Conclusions:

• Conservative management is a viable therapeutic option for ruptured spontaneous dissecting spinal aneurysms.
• This approach can achieve favorable angiographic and clinical outcomes.
• Further research into managing these rare lesions is warranted.