Next Article in Journal
Acute and Chronic Insomnia: What Has Time and/or Hyperarousal Got to Do with It?
Previous Article in Journal
Beneficial Effect of Foot Plantar Stimulation in Gait Parameters in Individuals with Parkinson’s Disease
Open AccessCase Report

Spontaneous Subarachnoid Hemorrhage in a Patient with a Co-Existent Posterior Communicating Artery Aneurysm and Cervical Spine Aneurysm Associated with Ventral Arterio-Venous Fistula

1
Department of Neurosurgery, J.E. Purkinje University, Masaryk Hospital, Sociální péče 12A, 40113 Ústí nad Labem, Czech Republic
2
International Clinical Research Center, St. Anne’s University Hospital, 38975 Brno, Czech Republic
3
Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Vídeňská 1083, 14220 Prague, Czech Republic
4
Department of Radiology, J. E. Purkinje University, Masaryk Hospital, 40113 Ústí nad Labem, Czech Republic
*
Author to whom correspondence should be addressed.
Brain Sci. 2020, 10(2), 70; https://doi.org/10.3390/brainsci10020070
Received: 16 January 2020 / Revised: 19 January 2020 / Accepted: 23 January 2020 / Published: 28 January 2020
(This article belongs to the Special Issue Neurosurgery for Cerebral Aneurysms)
Severe spontaneous subarachnoid hemorrhage (SAH) is predominantly caused by aneurysm rupture, with non-aneurysmal vascular lesions representing only a minority of possible causes. We present the case of a 58-year old lady with a coincidental posterior communicating artery (PCom) aneurysm and a high cervical spine arterio-venous fistula associated with a small ruptured aneurysm. After the emergency clipping of the PCom aneurysm, additional diagnostic procedures—repeated digital subtraction angiography and spinal magnetic resonance imaging, revealed the actual cause of the SAH, a type-A ventral intradural fistula at cervical level C2/3. The fistula was treated micro surgically via a ventral approach using C3 somatectomy and C2-4 stabilization after the initial failure of endovascular therapy. Furthermore, the patient was treated for complications associated with severe SAH, including acute hydrocephalus and meningitis. In cases where the SAH pattern and perioperative findings do not suggest an intracranial aneurysm as the source of SAH, further diagnostic investigation is warranted to discover the real cause. Patients with severe non-aneurysmal SAH require a similar algorithm in diagnosing the cause of the hemorrhage as well as complex conditions such as ruptured aneurysms.
Keywords: subarachnoid hemorrhage; spinal AV fistula; aneurysm; hydrocephalus subarachnoid hemorrhage; spinal AV fistula; aneurysm; hydrocephalus
MDPI and ACS Style

Aleš, H.; Jan, L.; Filip, C.; Martin, S. Spontaneous Subarachnoid Hemorrhage in a Patient with a Co-Existent Posterior Communicating Artery Aneurysm and Cervical Spine Aneurysm Associated with Ventral Arterio-Venous Fistula. Brain Sci. 2020, 10, 70.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop