Surgical management of cervical radiculomedullary arterial aneurysm with subarachnoid haemorrhage: a case report.

Abstract The aim of this paper was to report an unusual case of a 30-year-old woman admitted to the emergency department for a subarachnoid spinal haemorrhage. Clinical presentation was typical and the initial CT-scan did not show any intracranial lesions. Diagnosis was then confirmed by a full-spinal MRI that revealed a cervical radiculomedullary artery aneurysm. The diagnosis was also confirmed by an arteriography that showed a left C6 radiculomedullary artery aneurysm. Surgical management was performed and included a direct approach of the vascular lesion using an anterolateral cervicotomy and occlusion of the parent vessel. Histological examination confirmed the typical aspect of the aneurysm. The postoperative course was uneventful and the patient was discharged from hospital at day 15. This type of vascular lesion is very uncommon and requires a prompt diagnosis. Initial MRI can confirm the presence of a subarachnoid haemorrhage related to the aneurysm, which can be also visualized by an arteriography. Management of these vascular disorders requires a multidisciplinary specialized spine-team and is commonly performed using a direct surgical approach.