Lateral sacral artery aneurysm of the lumbar spine: hemorrhage resulting in cauda equina syndrome.
Keywords
Abstract
OBJECTIVE
To describe the effective treatment of a ruptured lateral sacral artery aneurysm presenting as a spinal epidural hematoma.
METHODS
Case report and literature review.
METHODS
University teaching hospital, neurovascular center.
METHODS
A man with a history of renal allograft who presented with sudden onset low back pain.
METHODS
The patient underwent emergent decompressive surgery, diagnostic angiogram and endovascular embolization.
METHODS
Obliteration of aneurysm and restoration of neurological function.
RESULTS
Surgery resulted in decompression of the cauda equina. The patient's aneurysm was endovascularly obliterated. There was complete restoration of neurological function.
CONCLUSIONS
Lateral sacral artery aneurysm formation and rupture is a rare cause of epidural hemorrhage and one described only in patients who have undergone renal transplantation. It may be caused by high flow from transpelvic collaterals between both internal iliac arteries. Treatment includes endovascular obliteration and may necessitate operative decompression in the setting of neurological compromise.
