Takayasu's arteritis complicated with subarachnoid hemorrhage and hematomyelia

Abstract

A 44-year-old woman presented with severe headache, drowsy mentality, and right hemiparesis. Brain computed tomography and magnetic resonance angiography revealed non-aneurysmal subarachnoid hemorrhage (SAH). Thoraco-abdominal and pelvic computed tomography angiography showed multiple steno-occlusive lesions involving the aorta and its large branches suggesting Takayasu's arteritis. Spine magnetic resonance imaging was taken because of prominent right hand muscle atrophy on the 14th hospital day, which showed subacute stage of hematomyelia in the cervical cord and conus medullaris. Aneurysmal or non-aneurysmal SAH is rare in patients with Takayasu's arteritis but SAH with coincidental hematomyelia is even more unusual. This case emphasizes the rarity of the coincidental spinal hematomyelia and its importance in the differential diagnosis.