Radiculopathy Caused by Internal Iliac Artery Pseudoaneurysm Managed with Endovascular Embolization

  • Choi, Il (Department of Neurosurgery College of Medicine Soonchunhyang University) ;
  • Im, Soo-Bin (Department of Neurosurgery College of Medicine Soonchunhyang University) ;
  • Kim, Bum-Tae (Department of Neurosurgery College of Medicine Soonchunhyang University) ;
  • Shin, Won-Han (Department of Neurosurgery College of Medicine Soonchunhyang University)
  • Published : 2007.12.28

Abstract

The authors describe a case of pseudoaneurysm arising from internal iliac artery presented with radiculopathy mimicking the symptoms of lumbar disc disease or spinal cord tumor. Among the several preoperative evaluation including CT, MRI, electrophysiologic study and ultrasonography, important diagnostic clue was obtained by ultrasonographic findings of turbulence flow at the core of partially enhanced mass in the pelvic cavity. The patient was managed with endovascular coil embolization successfully. The current case makes us remind that assessment of neurological symptoms on lower extremity should include consideration of extraspinal cause in pelvis.

Keywords

References

  1. Bickels J, Kahanovitz N, Rubert CK, Henshaw RM, Moss DP, Meller I, et al : Extraspinal bone and soft-tissue tumors as a cause of sciatica. Clinical diagnosis and recommendations : analysis of 32 cases. Spine 24 : 1611-1616, 1999 https://doi.org/10.1097/00007632-199908010-00017
  2. Buckley JG, Salimi Z, George E : Late onset renal allograft anastomotic pseudoaneurysm with absent Doppler signal. J Urol 148 : 392-394, 1992 https://doi.org/10.1016/S0022-5347(17)36608-9
  3. Chapman EM, Shaw RS, Kubik CS : Sciatic pain from arterisclerotic aneurysm of pelvic arteries N Engl J Med 271 : 1410-1411, 1964 https://doi.org/10.1056/NEJM196412312712708
  4. de Baere T, Ousehal A, Kuoch V, Sapoval M, Lagrange C, Roche A : Endovascular management of bleeding iliac artery pseudoaneurysms complicating radiation therapy for pelvic malignancies. AJR Am J Roentgenol 170 : 349-353, 1998 https://doi.org/10.2214/ajr.170.2.9456944
  5. de Godoy JM, Reis LF, Casagrande M, Braile DM : Treatment of internal iliac artery pseudoaneurysm by an endovascular approach. J Chin Med Assoc 68 : 435-436, 2005 https://doi.org/10.1016/S1726-4901(09)70160-1
  6. Donckier V, De Pauw L, Ferreira J, Hanquinet S, Hooghe L, Janssen F, et al : False aneurysm after transplant nephrectomy. Report of two cases. Transplantation 60 : 303-304, 1995 https://doi.org/10.1097/00007890-199508000-00021
  7. Dudeney S, O'Farrell D, Bouchier-Hayes D, Byrne J : Extraspinal causes of sciatica. A case report. Spine 23 : 494-496, 1998 https://doi.org/10.1097/00007632-199802150-00018
  8. Fleshner NE, Johnston KW : Repair of an autotransplant renal artery aneurysm : case report and literature review. J Urol 148 : 389-391, 1992 https://doi.org/10.1016/S0022-5347(17)36607-7
  9. Jeong CA, Park KH, Jo YG : An iliac arteriovenous fistula and pseudoaneurysm after lumbar disc surgery. J Korean Neurosurg Soc 36 : 415-418, 2004
  10. Kleiner JB, Donaldson WF 3rd, Curd JG, Thorne RP : Extraspinal causes of lumbosacral radiculopathy. J Bone Joint Surg Am 73 : 817- 821, 1991 https://doi.org/10.2106/00004623-199173060-00004
  11. Kopell HP, Thompson WA, Postel AH : Entrapment neuropathy of the ilioinguinal nerve. N Engl J Med 266 : 16-19, 1962 https://doi.org/10.1056/NEJM196201042660105
  12. Ladha SS, Spinner RJ, Suarez GA, Amrami KK, Dyck PJ : Neoplastic lumbosacral radiculoplexopathy in prostate cancer by direct perineural spread : an unusual entity. Muscle Nerve 34 : 659-665, 2006 https://doi.org/10.1002/mus.20597
  13. Larson J, O'Malley JE, Cohen TI : Case report : solitary pelvic osteochondroma presenting with L3 nerve root compression. Alaska Med 44 : 35-37, 2002
  14. Luzzio CC, Waclawik AJ, Gallagher CL, Knechtle SJ : Iliac artery pseudoaneurysm following renal transplantation presenting as lumbosacral plexopathy. Transplantation 67 : 1077-1078, 1999 https://doi.org/10.1097/00007890-199904150-00026
  15. Papadopoulos SM, McGillicuddy JE, Messina LM : Pseudoaneurysm of the inferior gluteal artery presenting as sciatic nerve compression. Neurosurgery 24 : 926-928, 1989 https://doi.org/10.1227/00006123-198906000-00025
  16. Parodi JC : Endovascular repair of aortic aneurysms, arteriovenous fistulas, and false aneurysms. World J Surg 20 : 655-663, 1996 https://doi.org/10.1007/s002689900100
  17. Todd GJ, DeRose JJ, Martin EC : Complementary surgical/interventional techniques for nonresective management of 'inoperable' aneurysms : a second look. Ann Vasc Surg 12 : 248-254, 1998 https://doi.org/10.1007/s100169900148
  18. Vetto JT, Culp SC, Smythe TB, Chang AE, Sindelar WF, Sugarbaker PH, et al : Iliac arterial-enteric fistulas occurring after pelvic irradiation. Surgery 101 : 643-647, 1987
  19. Wilberger Jr JE : Lumbosacral radiculopathy secondary to abdominal aortic aneurysms. Report of three cases. Neurol clin 58 : 965-967, 1983