Subarachnoid and intraperitoneal hemorrhage secondary to segmental arterial mediolysis: A case report and review of the literature

Brian T. Welch, Waleed Brinjikji, Andrew H. Stockland, Giuseppe Lanzino

Research output: Contribution to journalArticle

5 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)378-381
Number of pages4
JournalInterventional Neuroradiology
Issue number4
StatePublished - Aug 1 2017



  • hemorrhage
  • SAM
  • spinal aneurysms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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