Ruptured aneurysm of the artery of Adamkiewicz as a rare cause of spinal cord injury

A man in his 60s presented with back pain, headache, and urinary retention and later developed altered mental status and right lower extremity weakness. Imaging revealed a ruptured aneurysm of the artery of Adamkiewicz, a rare cause of spinal cord injury. The patient was managed conservatively and showed significant recovery at 11-week follow-up, regaining function and independence. Spinal angiogram at 15 weeks showed spontaneous resolution of the aneurysm. This case, along with previous reports, highlights the importance of considering spinal artery aneurysms in cases of subarachnoid hemorrhage without a clear cause, and demonstrates the potential for neurological and functional recovery.

• 1
  Ruptured aneurysms of the artery of Adamkiewicz are a rare cause of spinal cord injury and subarachnoid hemorrhage, with only 13 cases reported in the literature including the present case.
• 2
  Conservative management of ruptured artery of Adamkiewicz aneurysms can lead to neurological and functional recovery, with many patients achieving modified independence within 3 months.
• 3
  Back pain is the most common presenting symptom in patients with ruptured artery of Adamkiewicz aneurysms, often accompanied by lower extremity paraplegia or paresthesia.