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Both spinal artery aneurysm and spinal subarachnoid hemorrhage represent a very rare event. We report a case of a ruptured dissecting aneurysm of the right L1 radiculomedullary artery associated with subarachnoid hemorrhage and severe motor weakness. An urgent decompressive hemilaminectomy was performed due to worsening in motor deficit. A subsequent spinal angiography showed a dissection of radiculomedullary artery of L1 on the right side, treated conservatively. Nowadays, therapeutic strategies for this aneurysm remain controvers
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