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A 66-year-old man presented with a 6-day history of progressive posterior cervical pain that included lower back pain and fever. Neurological examinations revealed neck stiffness. Computed tomography demonstrated convexity subarachnoid hemorrhage. A spinal T2-weighted image revealed a hypointense signal lesion with contrast enhancement of the intradural extramedullary space at Th12-L1. Digital subtraction angiography showed a fusiform aneurysm with a 10 mm diameter in the artery of Adamkiewicz. We diagnosed the patient's condition as a ruptured aneurysm of the artery of Adamkiewicz. By day 41 the aneurysm had disappeared following conservative treatment. Aneurysms arising from the artery of Adamkiewicz are extremely rare and can cause both convexity and spinal subarachnoid hemorrhages. Clinicians should therefore look for spinal lesions if patients with convexity subarachnoid hemorrhage of an unknown origin have lower back pain as their initial symptom.
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.105224 | DOI Listing |
Front Neurol
August 2025
Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, United States.
Introduction: The diagnosis of acute central retinal artery occlusion (CRAO) is commonly delayed in emergency departments (ED) where ophthalmologists are rarely available for immediate consultation. Thrombolysis is sometimes given empirically for presumed CRAO without confirmation of the diagnosis with ocular funduscopic examination.
Methods: We describe one case of severe intraocular hemorrhage following intravenous thrombolysis for a retinal detachment misdiagnosed as a CRAO, and two cases of worsening intraocular hemorrhage following intravenous thrombolysis for misdiagnosed CRAO, and review the literature.
Neuroradiol J
August 2025
Division of Neuroradiology, University Medical Imaging Toronto and Joint Department of Medical Imaging, University Health Network, Toronto Western Hospital, Toronto, ON, Canada.
Spinal epidural arteriovenous fistulas (SEAVFs) with intradural reflux are rare but important vascular lesions that may cause progressive myelopathy due to spinal cord venous hypertension. Although traditionally managed by means of arterial embolization or surgical disconnection, these approaches can pose risks, particularly when critical vascular structures, such as the artery of Adamkiewicz, originate in close proximity to the fistulous site. We report the case of a patient in their 60s who presented with progressive paraparesis over approximately 1 year, ultimately attributed to an SEAVF located adjacent to the right L1-L2 neural foramen, with radiculo-perimedullary reflux.
View Article and Find Full Text PDFJACC Case Rep
August 2025
Oregon Health & Science University, Portland, Oregon, USA. Electronic address:
Background: Abdominal coarctation of the aorta is rare, and it poses unique procedural challenges when located near the artery of Adamkiewicz.
Case Summary: We describe a 4-year-old female patient who was found to have an abdominal coarctation of the aorta at the level of the diaphragm. Despite normal growth and minimal symptoms, the patient had significant upper-to-lower extremity blood pressure gradients and developed hypertension.
Eur Spine J
August 2025
Department of Neurosurgery, Medical Research Institute, Kitano Hospital, PIIF Tazuke-Kofukai, Osaka, Japan.
Purpose: Complete resection of spinal cord tumors in the thoracic region requires precise preservation of critical vascular structures such as the Adamkiewicz artery. This report highlights the utility of narrow band imaging (NBI) in achieving complete schwannoma removal, while preserving vascular integrity.
Case Presentation: A 72-year-old male presented with left lower extremity weakness persisting for four months.
Clin Radiol
July 2025
Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, South Korea. Electronic address:
Aim: The use of iterative model-based reconstruction (IMR) for the artery of Adamkiewicz (AKA) visualisation using low-dose computed tomography (CT) angiography remains understudied. Therefore, we aimed to compare the image quality and AKA visualisation using a novel knowledge-based IMR with those using hybrid iterative reconstruction (iDose) and filtered back projection (FBP) under a low-dose CT protocol.
Materials And Methods: Forty-five patients (73.