A Rare Case of Isolated Spinal Aneurysm: Presentation of a New Case and Review of the Literature

Introduction: Spinal aneurysms (SAs) are rare and only a few cases are reported. The exact etiology of their formation is still unknown. Methods: We reviewed the literature looking for cases of isolated spinal artery aneurysms (ANs) and, in particular, those involving the anterior arterial group of the spinal cord. Results: Our literature research allowed us to find, to date, 94 publications reporting 131 cases of isolated spinal artery ANs. Data available about these cases are reported and analyzed in the first part of this work. We then presented a new case: A 65‐year‐old female presented with headache and backache. She was subjected to radiological tests documenting the presence of cerebral subarachnoid hemorrhage (SAH) with focal blood collection at the D8–D9 level. The spinal angiography showed an AN of the anterior radicular medullary artery (ARMA). A conservative therapeutic strategy was decided, and the patient was discharged from the hospital in good general condition. Discussion: SAs can be divided into different types depending on the presence of arteriovenous malformations (AVMs) and on their location at the level of the spinal arteries. The clinical presentation is variable, including acute and rapidly progressing symptoms caused by hemorrhage or neurological deficits due to mass effect of hematoma, AN, AVMs, or arteriovenous fistulas (AVFs). The outcome correlates with the clinic and, therefore, with the severity of the specific case. Conclusion: We report a rare case of ARMA AN underlining how this entity is often misunderstood, and therefore, it is important to consider them in the differential diagnosis of spinal lesions. We believe that future studies will be important in order to learn more about the natural history and to characterize the appropriate therapeutic strategies of SAs.