TY - JOUR
T1 - Subarachnoid and intraperitoneal hemorrhage secondary to segmental arterial mediolysis
T2 - A case report and review of the literature
AU - Welch, Brian T.
AU - Brinjikji, Waleed
AU - Stockland, Andrew H.
AU - Lanzino, Giuseppe
N1 - Publisher Copyright:
© The Author(s) 2017.
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Background Segmental arterial mediolysis (SAM) is an uncommon or underdiagnosed arteriopathy that presents with life-threatening hemorrhage. SAM can affect the intracranial, spinal, and visceral arteries, with reported cases of concomitant intracranial and visceral hemorrhage. Case description We present the case of a 61-year-old male with concurrent subarachnoid and intraperitoneal hemorrhage caused by simultaneously bleeding posterior spinal artery and splenic artery pseudoaneurysms. The posterior spinal artery pseudoaneurysms were treated with selective injection of polyvinyl alcohol particles into the posterior spinal artery, while the splenic artery pseudoaneurysm was treated with Gelfoam embolization. The constellation of imaging, clinical, and laboratory features led to a presumptive diagnosis of SAM, which remains the only reported cause of concurrent neurovascular and visceral artery aneurysm rupture. Conclusion SAM is a key diagnostic consideration in cases of concomitant intracranial, spinal, and visceral artery aneurysm rupture.
AB - Background Segmental arterial mediolysis (SAM) is an uncommon or underdiagnosed arteriopathy that presents with life-threatening hemorrhage. SAM can affect the intracranial, spinal, and visceral arteries, with reported cases of concomitant intracranial and visceral hemorrhage. Case description We present the case of a 61-year-old male with concurrent subarachnoid and intraperitoneal hemorrhage caused by simultaneously bleeding posterior spinal artery and splenic artery pseudoaneurysms. The posterior spinal artery pseudoaneurysms were treated with selective injection of polyvinyl alcohol particles into the posterior spinal artery, while the splenic artery pseudoaneurysm was treated with Gelfoam embolization. The constellation of imaging, clinical, and laboratory features led to a presumptive diagnosis of SAM, which remains the only reported cause of concurrent neurovascular and visceral artery aneurysm rupture. Conclusion SAM is a key diagnostic consideration in cases of concomitant intracranial, spinal, and visceral artery aneurysm rupture.
KW - SAM
KW - hemorrhage
KW - spinal aneurysms
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U2 - 10.1177/1591019917703074
DO - 10.1177/1591019917703074
M3 - Article
C2 - 28443482
AN - SCOPUS:85026669997
SN - 1591-0199
VL - 23
SP - 378
EP - 381
JO - Interventional Neuroradiology
JF - Interventional Neuroradiology
IS - 4
ER -