Clinical problem-solving: Aneurysm or spinal arteriovenous fistula-bait and switch

Jeffrey F. Lastfogel, Bernard R. Bendok, Nicholas M. Boulis, Aaron A. Cohen-Gadol

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Objective: The authors use an instructive case to review the challenges of diagnosis in subarachnoid hemorrhage (SAH) and to reinforce the nuances of clinical management. Importance: The presented case highlights critical issues in patient selection and challenges in the diagnosis of SAH and the management of both aneurysmal and arteriovenous fistula-related SAH. The critical points in decision making and diagnosis are discussed, and the case is accompanied by a brief review of the literature on the issues being faced. Clinical Presentation: The present case is a patient presenting with SAH who was found to have an anterior communicating artery aneurysm. However, clues in the presentation and workup point to another etiology. Conclusion: A strong history of sudden neck pain before headache and abundance of SAH along the brainstem mandates a need to thoroughly evaluate the source of hemorrhage from cervical vessels through an angiogram.

Original languageEnglish (US)
Pages (from-to)E866-E873
Issue number3
StatePublished - Mar 2011


  • Endovascular repair
  • Spinal arteriovenous fistula
  • Subarachnoid hemorrhage
  • Surgical clipping

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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