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We analyzed demographics, clinical presentation, imaging findings, treatments, and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified seven patients (mean age 48; 4 women) with nine ISAs, eight of which were managed conservatively. Five of them had excellent short-term outcomes, and spontaneous regression was documented in four cases. With our cases, 208 ISAs have been reported in the literature in 164 patients (mean age 51; 52% female). They most commonly present with subarachnoid hemorrhage (90%) and back pain (69%). Most are located in the thoracic (51%) or cervical spine (40%) and involve the anterior spinal circulation (63%). They may be treated by surgical intervention (47%) or conservatively (37%), less commonly by endovascular therapy (16%). 78% of patients have favorable outcomes (mRS 0\u20133), similar across all treatment approaches. In 52% of conservatively managed cases, spontaneous regression was documented by imaging. Clinical deterioration was primarily associated with respiratory complications and spinal cord infarction, with a documented rebleeding rate of 8% and a mortality rate of 12%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ISAs are a rare and potentially underrecognized cause of cerebral and spinal subarachnoid hemorrhage. In select cases, particularly small ISAs of the anterior spinal or a radiculomedullary artery and with transient neurological symptoms, conservative management appears to be a reasonable approach, supported by increasing evidence of the possibility of spontaneous regression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10143-025-03768-8","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T09:47:51Z","timestamp":1757324871000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Isolated spinal aneurysms with spontaneous regression"],"prefix":"10.1007","volume":"48","author":[{"given":"Vivien","family":"Richter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Khanafer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0286-8781","authenticated-orcid":false,"given":"Sven","family":"Poli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra G\u00f3mez","family":"Exp\u00f3sito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Haas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantin","family":"Roder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Ernemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Henkes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Hennersdorf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"issue":"2","key":"3768_CR1","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1007\/s10143-021-01645-8","volume":"45","author":"S Alomari","year":"2022","unstructured":"Alomari S, Xu R, Huang J, Tamargo R, Bydon A (2022) Isolated aneurysms of the spinal circulation: a systematic review of the literature. 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