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Updated: Aug 29, 2025

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
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Hemorrhage due to a pseudoaneurysm on a dural-pial anastomosis after decompression for Chiari malformation type I:

Rasmus Holmboe Dahl1,2, Jesper Kelsen1, Klaus Hansen3

  • 1Department of Radiology, University Hospital Rigshospitalet, Copenhagen, Denmark.

Acta Neurochirurgica
|September 5, 2022
PubMed

While intracranial aneurysms rarely develop after neurosurgical procedures, delayed pseudoaneurysm formation after foramen magnum decompression (FMD) has never been reported. A 52-year-old woman presented with an atypical subarachnoid hemorrhage in the posterior fossa 12 years after a FMD for symptomatic Chiari malformation type I was performed. A pseudoaneurysm on a dural-pial anastomosis was identified as the bleeding source and successfully occluded by endovascular means with full clinical recovery of the patient. Injury to the distal posterior inferior cerebellar artery related to surgery and postoperative infection likely caused formation of a dural-pial anastomosis. Additionally, hemodynamic stress or dissection may have contributed to delayed pseudoaneurysm formation and rupture.

Keywords:
Case reportChiari malformation type IDural-pial anastomosisForamen magnum decompressionPseudoaneurysmTransmastoid branch of the occipital artery

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