{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T05:42:37Z","timestamp":1786167757664,"version":"build-2736575974"},"reference-count":15,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T00:00:00Z","timestamp":1715040000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Interv Neuroradiol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>In this study, we address the rarity and management challenges associated with ruptured spinal artery pseudoaneurysms, which comprise &lt; 1% of subarachnoid hemorrhage cases. With our limited understanding of their natural history, the prevailing consensus leans towards surgical clipping, contrasting with the typically benign symptoms of sudden back pain and lower extremity weakness. Despite reported low morbidity and mortality, fatal re-ruptures underscore the need for effective management strategies. In this context, we present the largest case series to date, featuring five patients with spinal subarachnoid hemorrhage from isolated posterior spinal artery pseudoaneurysms. All cases achieved spontaneous thrombosis and resolution through conservative management, challenging the prevailing surgical emphasis. The patients, aged 58\u201381, exhibited varied symptoms, including back pain, paresthesia, confusion, and seizures, with hypertension as a common comorbidity. The results of these cases lead us to tender a \u201chybrid\u201d management strategy, combining conservative measures with short-term follow-up angiograms, fostering a paradigm shift and warranting further investigation into individualized patient care within larger clinical cohorts.<\/jats:p>","DOI":"10.1177\/15910199241249779","type":"journal-article","created":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T01:36:07Z","timestamp":1715132167000},"page":"1998-2001","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Spontaneous thrombosis with a conservative approach to posterior spinal artery pseudoaneurysm management: A case series"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0971-826X","authenticated-orcid":false,"given":"Yasaman","family":"Pirahanchi","sequence":"first","affiliation":[{"name":"Swedish Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Atchie","sequence":"additional","affiliation":[{"name":"Swedish Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Flynn","sequence":"additional","affiliation":[{"name":"Swedish Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Kaminsky","sequence":"additional","affiliation":[{"name":"Swedish Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,5,7]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-63640-9.00020-5"},{"key":"e_1_3_2_3_2","volume-title":"StatPearls","author":"Hasan S","year":"2023","unstructured":"Hasan S, Arain A. Neuroanatomy, spinal cord arteries. In: StatPearls. Updated August 15, 2022. Treasure Island, Fl: StatPearls Publishing, 2023. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK539889\/"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-021-02055-5"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/159101991001600211"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2015.11.015"},{"key":"e_1_3_2_7_2","article-title":"Posterior spinal artery aneurysm as an unlikely culprit for perimesencephalic pattern subarachnoid hemorrhage: illustrative case","volume":"1","author":"Malhotra AK","year":"2021","unstructured":"Malhotra AK, Ku JC, Pereira VM, et al. Posterior spinal artery aneurysm as an unlikely culprit for perimesencephalic pattern subarachnoid hemorrhage: illustrative case. J Neurosurg 2021; 1: CASE21103. (accessed 17 August 2023).","journal-title":"J Neurosurg"},{"key":"e_1_3_2_8_2","first-page":"405","article-title":"Solitary spinal artery aneurysms as a rare source of spinal subarachnoid hemorrhage: potential etiology and treatment strategy","volume":"26","author":"Berlis A","year":"2005","unstructured":"Berlis A, Scheufler KM, Schmahl C, et al. Solitary spinal artery aneurysms as a rare source of spinal subarachnoid hemorrhage: potential etiology and treatment strategy. AJNR Am J Neuroradiol 2005; 26: 405\u2013410.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_2_9_2","first-page":"2415","article-title":"Subarachnoid hemorrhage due to isolated spinal artery aneurysm in four patients","volume":"26","author":"Massand MG","year":"2005","unstructured":"Massand MG, Wallace RC, Gonzalez LF, et al. Subarachnoid hemorrhage due to isolated spinal artery aneurysm in four patients. 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Ruptured isolated spinal artery aneurysms: Case series of five patients and a review of the literature on management strategies. 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