Ruptured aneurysms of the intradural artery of adamkiewicz: Angiographic features and treatment options

•Spinal avm is a rare phenomenon.•Treatment modalities are varied, but there is no clear dominant approaches.•Conservative management is successful

We present an unusual case of a 59 year old male patient who presented with acute, bilateral lower extremity weakness and was found to have non-traumatic spinal subarachnoid hemorrhage. Diagnostic workup including MRI and angiography revealed an aneurysm of the artery of Ademkiewicz. This was managed conservatively and the patient has had marked clinical improvement. We present the details of this unusual case as well as a literature review related to aneurysms of the artery of Ademkiewicz.