Aneurysm and Fenestration of the Azygos Anterior Cerebral Artery-Case Report-

Ihara, Satoshi; Uemura, Kazuya; Tsukada, Atsuro; Yanaka, Kiyoyuki; Nose, Tadao

doi:10.2176/nmc.43.246

Cited by 13 publications

(12 citation statements)

References 22 publications

(46 reference statements)

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“…Fenestration of arteries, described as division of arterial lumen into separate channels, each having a unique endothelial and muscularis layer, is commonly seen in cerebral arteries [1,2]. Angiographic incidence of arterial fenestration is 0.3 to 0.9 %, and they were thought to be more common in posterior circulation [1][2][3].…”

Section: Discussionmentioning

confidence: 99%

“…Angiographic incidence of arterial fenestration is 0.3 to 0.9 %, and they were thought to be more common in posterior circulation [1][2][3]. However two studies conducted by Van Rooij et al [4,5] demonstrated that fenestrations are more common in anterior circulation by using the more sensitive diagnostic modality, namely three-dimensional rotational angiography (3DRA).…”

Section: Discussionmentioning

confidence: 99%

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Fenestrated azygos A2 segment: a rare anatomic variation

Rahmanian

Derakhshan

2015

Neurovascular Imaging

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Advancement in neurovascular imaging has led to detection of abnormalities and normal anatomic variations. Most of anatomical variations in cerebral vasculature are asymptomatic and found incidentally; however, some may increase the risk of aneurysm formation and subsequent subarachnoid or intracranial hemorrhage. Here in, we report fenestration within an azygos A2 segment, as an incidental finding, which is an extremely rare anatomic variation in a patient suffering subarachnoid hemorrhage (SAH). However, there was no correlation found between SAH and the mentioned anatomic variation. To author's knowledge this is the first report of such anatomic variation with providing source images of brain CT angiograms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fenestrated azygos A2 segment: a rare anatomic variation

Rahmanian

Derakhshan

2015

Neurovascular Imaging

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“…This failure would possibly increase blood flow in one of the A1 segments because of the contralateral A1 hypoplasia, resulting in increased hemodynamic stress on the ipsilateral A1 segment. Such increased blood flow and hemodynamic stress would prevent normal fusion of the plexiform anastomosis in the distal primitive ACA, resulting in formation of the A1 fenestration, and could also cause aneurysm formation on the fenestrated A1 segment4). However, the pathophysiologic mechanism for the development of fenestrated A1 segment is still not clearly understood.…”

Section: Discussionmentioning

confidence: 99%

“…There are two theories for azygos ACA formation. Abnormal fusion of paired A2 from the medial branch of the primitive olfactory artery at the 16-mm stage of the embryo, and persistence of the median artery of the corpus callosum at the 20- to 24-mm stage may involve in the regression or lack of development of the ACAs4,8,15). The azygos ACA is known to be closely associated with the occurrence of saccular aneurysms1,2).…”

Section: Discussionmentioning

confidence: 99%

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Ruptured Saccular Aneurysm Arising from Fenestrated Proximal Anterior Cerebral Artery : Case Report and Literature Review

Kwon

Park

et al. 2013

J Korean Neurosurg Soc

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The aneurysm arising from fenestrated proximal anterior cerebral artery (ACA) is considered to be unique. The authors report a case of a 59-year-old woman who presented with a subarachnoid hemorrhage (SAH) secondary to a ruptured aneurysm originating from the fenestrated A1 segment of right ACA. The patient had another unruptured aneurysm which was located at the right middle cerebral artery bifurcation. She was successfully treated with surgical clipping for both aneurysms. From the previously existing literatures, we found 18 more cases (1983-2011) of aneurysms associated with fenestrated A1 segment. All cases represented saccular type of aneurysms, and 79% of the patients had SAH. There were three subtypes of the fenestrated A1 aneurysms depending on the anatomical location, relative to the fenestrated segment. The most common type was the aneurysms located on the proximal end of fenestrated artery (82%). Azygos ACA and hypoplastic A1 were frequently accompanied by the aneurysm (33% and 31%, respectively), and multiple aneurysms were shown in three cases (16%). Considering that fenestrated A1 segment is likely to develop an aneurysm, which has high risk of rupture, early management may benefit patients with aneurysms accompanied by fenestrated proximal ACA.

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Essential Neurovascular Anatomy

Harrigan

Deveikis

2009

Handbook of Cerebrovascular Disease and Neurointerventional Technique

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Aneurysm and Fenestration of the Azygos Anterior Cerebral Artery-Case Report-

Cited by 13 publications

References 22 publications

Fenestrated azygos A2 segment: a rare anatomic variation

Fenestrated azygos A2 segment: a rare anatomic variation

Ruptured Saccular Aneurysm Arising from Fenestrated Proximal Anterior Cerebral Artery : Case Report and Literature Review

Essential Neurovascular Anatomy

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