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Isolated spinal aneurysms with spontaneous regression.

Vivien Richter1, Ali Khanafer2, Sven Poli3

  • 1Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany. vivien.richter@med.uni-tuebingen.de.

Neurosurgical Review
|September 8, 2025
PubMed
Summary
This summary is machine-generated.

Conservative management of isolated spinal arterial aneurysms (ISAs) shows promise, with spontaneous regression observed in many cases. This approach may be suitable for select small ISAs, particularly those in the anterior spinal artery or radiculomedullary artery.

Keywords:
Spinal aneurysmSpinal angiographySpinal hemorrhageSubarachnoid hemorrhage

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Area of Science:

  • Neurology
  • Vascular Surgery

Background:

  • Isolated spinal arterial aneurysms (ISAs) are rare vascular malformations.
  • They can present with subarachnoid hemorrhage and neurological deficits.

Purpose of the Study:

  • To evaluate the clinical experience with conservative management of ISAs.
  • To identify suitable clinical scenarios for conservative ISA treatment.

Main Methods:

  • Retrospective review of spinal angiograms from two centers.
  • Systematic literature review of reported ISA cases.
  • Analysis of demographics, presentation, treatment, and outcomes.

Main Results:

  • Eight of nine ISAs in the study cohort were managed conservatively with excellent short-term outcomes.
  • Spontaneous regression occurred in 4/8 conservatively managed ISAs.
  • Literature review of 208 ISAs showed favorable outcomes (78%) across treatment modalities; 52% of conservatively managed cases showed spontaneous regression.

Conclusions:

  • ISAs are an underrecognized cause of spinal subarachnoid hemorrhage.
  • Conservative management is a viable option for select small ISAs, especially with evidence of spontaneous regression.
  • Small ISAs in the anterior spinal or radiculomedullary artery with transient symptoms warrant consideration for conservative treatment.