Posterior Spinal Artery Territory Syndrome Following Treatment of a Basilar Artery Aneurysm with a Pipeline Embolization Device: A Case Report

Authors

  • Ahmad S Ali Faculty/Staff within Rutgers New Jersey Medical School, Neurology Department, USA Author
  • Sudheesh Ramachandran Faculty/Staff within Rutgers New Jersey Medical School, Neurology Department, USA Author
  • Volodymyr Vulkanov Faculty/Staff within Rutgers New Jersey Medical School, Neurology Department, USA Author
  • Priyank Khandelwal Faculty/Staff within Rutgers New Jersey Medical School, Neurology Department, USA Author
  • Machteld Hillen Faculty/Staff within Rutgers New Jersey Medical School, Neurology Department, USA Author

DOI:

https://doi.org/10.47363/JNRRR/2024(6)176

Keywords:

Spinal, Pipeline Embolization Device, Territory Syndrome

Abstract

Posterior spinal artery infarcts are exceedingly rare due to high level of collateral circulation in the spinal cord. Additionally thromboembolic phenomenon is a potential complication during aneurysm stenting via digital subtraction angiography (DSA). Hereby, we report a case of posterior spinal artery syndrome following cerebral angiography and endovascular basilar artery pipeline embolization (PED) for basilar artery aneurysm. Our goal is to outline successful diagnosis and management of this rare event. Our patient is a 59-year-old female with a basilar artery aneurysm. Following treatment of an intracranial proximal basilar artery aneurysm with a Pipeline Embolization Device, she presented as bilateral dorsal cord syndrome. On exam, she had isolated findings of loss of vibration and joint position sense in her feet and ankles, accompanied by the presence of T2 hyperintensity in the nuclei gracilis at C2-3 on MRI cervical spine is consistent with arterial thromboembolism during her procedure. Although posterior spinal artery infarct is infrequently reported in the literature, it is a potential complication of posterior fossa endovascular intervention. The presence of sensory symptoms following a basilar artery procedure should alert physicians to involvement of the dorsal columns of the upper cervical cord due to PSA ischemia.

Author Biographies

  • Ahmad S Ali, Faculty/Staff within Rutgers New Jersey Medical School, Neurology Department, USA

    Faculty/Staff within Rutgers New Jersey Medical School, Neurology Department, USA

  • Sudheesh Ramachandran, Faculty/Staff within Rutgers New Jersey Medical School, Neurology Department, USA

    Faculty/Staff within Rutgers New Jersey Medical School, Neurology Department, USA

  • Volodymyr Vulkanov, Faculty/Staff within Rutgers New Jersey Medical School, Neurology Department, USA

    Faculty/Staff within Rutgers New Jersey Medical School, Neurology Department, USA

  • Priyank Khandelwal, Faculty/Staff within Rutgers New Jersey Medical School, Neurology Department, USA

    Faculty/Staff within Rutgers New Jersey Medical School, Neurology Department, USA

  • Machteld Hillen, Faculty/Staff within Rutgers New Jersey Medical School, Neurology Department, USA

    Faculty/Staff within Rutgers New Jersey Medical School, Neurology Department, USA

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Published

2024-11-25

Issue

Vol. 6 No. 11 (2024): Volume 6 Issue 11

Section

Articles