Tratamiento quirúrgico de aneurisma de la arteria espinal posterior roto. Reporte de un caso y revisión de la literatura Surgical treatment of ruptured posterior spinal artery aneurysm. Case report and literature review

Aneurysms of the Posterior spinal artery (PSA) usually present secondary to high-flow pathologies such as arteriovenous malformations or dural arteriovenous fistulas, also can be associated whit collagen diseases. Isolate PSA aneurysms are rare, whit 11 cases reported, to our knowledge. We present a 56 years old patient, user of oral anticoagulant for an old isquemic stroke, secondary to atrial fibrillation, who presented whit subit lumbar pain and flaccid paraplejia. The magnetic resonance image shows an extensive spinal subarachnoid hemorrhage and secondary medular compression. Spinal angiography study demonstrated a dissecting aneurysm of PSA. Due to the small size of the artery, on which the aneurysm was located, surgical treatment was performed. Follow up angiography shows complete exclusion of the lesion. The patient has had a progressive recovery on her deficit. Both surgical and endovascular treatment have been reported. The present case shows that early surgical treatment is an option, especially if medular decompression is needed.