Angiographic Pitfall: Duplicated Tapered A1 Segment of the Anterior Cerebral Artery Mimicking an Anterior Communicating Artery Aneurysm

Weil, Arthur; Bojanowski, Michel W.; Scholtes, Félix; Darsaut, T.E.; Signorelli, Francesco; Weill, Alain

doi:10.1177/159101991101700206

Cited by 14 publications

(11 citation statements)

References 37 publications

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“…The results of such studies would be useful when planning surgical approaches [ 25 ], and would allow to avoid any unexpected anatomical variations during treatment of ACoA aneurysms. Such anatomical problems may include double fenestrations of the A2 segment mimicking an aneurysm neck [ 18 ] or mistaking a duplicated A1 segment for an ACoA aneurysm [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

Anatomical variations of the anterior communicating artery complex: gender relationship

et al. 2014

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PurposeThe anatomy of the anterior communicating artery complex plays a critical role in surgical treatment of anterior cerebral circulation aneurysms. A thorough description of vascular variations of the anterior communicating artery complex seems to be lacking. The aim of this study was to describe the anatomical variations of the anterior communicating artery complex.MethodsThe study group consisted of 411 subjects (52.31 % women), without any intracranial pathologies, that had undergone head computed tomography angiography. We used maximum intensity projections, volume rendering and multi planar reconstructions to study and classify the anatomical variations of the anterior communicating and anterior cerebral arteries.ResultsMale subjects had a significantly higher prevalence of the typical anterior communicating artery complex (59.69 vs. 46.05 %; p < 0.01). The aplastic anterior communicating artery (23.26 vs. 15.88 %; p = 0.04) and triple A2 segment of the anterior cerebral artery (1.86 vs. 0.00 %; p = 0.05) were more common in women than in men.ConclusionFemale subjects have a higher incidence of variations in the anterior communicating artery complex. There is a higher incidence of anterior communicating artery aplasia among women.

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Section: Introductionmentioning

confidence: 99%

Anatomical variations of the anterior communicating artery complex: gender relationship

et al. 2014

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“…The results of such studies would be useful when planning surgical approaches, and would allow to avoid any unexpected anatomical variations during ACoA aneurysms' treatment. Such anatomical problems may include double fenestrations of the A2 segment mimicking an aneurysm neck or mistaking a duplicated A1 segment for an ACoA aneurysm [41][42][43] .…”

Section: Anatomical Considerations Of Acoamentioning

confidence: 99%

Anterior Communicating Artery Aneurysms

Rabelo¹,

Pereira²,

Sant'Anna³

et al. 2018

jbnc

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Introduction: Anterior communicating artery complex (ACoA) is the most frequent intracranial aneurysms (30%) and the most complex of the anterior circulation, due to variation of architecture, flow and many branches involved. This paper aims toestablish anatomical study and clinical manifestations, analyzing a series of cases of AcoA aneurysms. Methods: Articles in PubMed, Scientific Direct were reviewed using as key words, anatomy variations. In addition, AcoA features were analyzedbased on our series cases. Results: Most common anatomical variations found in the literature were: plexiform (30%), curling (33%), fenestration (21%), duplication (18%). Clinical features: Fasciobraquial hemiparesis, headache, personality changes,intellectual deficit, anxiety, fear, emotional disturbances, dizziness, agitation, hypokinesia, decreased level of consciousness. Total of 5-year series of 234 cerebral aneurysms (32 deaths -13.6 %). Analyzing the series, 41 ACoA (18%), with 32 ruptured (78%); 19 deaths (46%); 16 prior hypertension arterial (39%); and a ratio between women and men of 2.25 were found. Conclusion: In our series, we concluded that the ACoA aneurysms are more common in women, the diagnosis is often after rupture and highincidence of death. Probably the anatomical variations, location between bifurcation arteries, A1 characteristics and different direction of the domus, contribute for different outcomes and uncertain clinics. Therefore, to predict the topography of theaneurysm by analyzing only the clinic is difficult.

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“…ACoA, A1, A2 segments, and the recurrent artery of Heubner are collectively known as the AcoA complex [1]. Anatomical variations in this complex are common and are detected in 58-85% of all patients with ACoA aneurysms [2]. A range of different arterial variations was indexed, including fenestration, duplication, trifurcation, hypoplasia, and aplasia [3].…”

Section: Introductionmentioning

confidence: 99%

“…Also, these anatomical variations can mimic intracranial aneurysms by the superimposition of a duplicated or a fenestrated vessel [2]. Furthermore, the net-result of the hemodynamic changes in these variations plays a considerable role in the development of several vascular pathologies, such as aneurysms and ischemic strokes [3].…”

Section: Introductionmentioning

confidence: 99%

Enlarged anterior communicating artery masquerading as intracranial aneurysm

Albanaa¹,

Al-Sharshahi²,

Hummadi³

et al. 2020

roneuro

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Background. The anterior communicating artery (ACoA) complex consists of the ACoA, the pre-and post-communicating segments of the anterior cerebral artery, and the recurrent artery of Heubner. It is the most common site for anatomical variations in the circle of Willis. Such variations can mimic intracranial aneurysms. Case description. A 30-year-old female presented with recurrent episodes of extreme headache and bilateral tinnitus. A brain computed tomography (CT) scan showed no significant lesions, while her CT-angiography (CTA) showed an enlarged vascular lesion at the ACoA, raising the suspicion for an ACoA aneurysm. A repeated CTA revealed a rare anatomical variation with a pattern of cross dominance in the ACoA complex; the left A1 and right A2 were dominant-enlarged, resulting in an enlargement of the ACoA. The presence of an ACoA aneurysm was hence excluded and the patient was managed conservatively. At 6-month follow-up, CTA showed no new findings. Conclusion. ACoA enlargement can result from unequal hemodynamics around the ACoA complex, which may be mistaken for an aneurysm. A thorough study of the imaging data is of pivotal importance and may change the management strategy.

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Angiographic Pitfall: Duplicated Tapered A1 Segment of the Anterior Cerebral Artery Mimicking an Anterior Communicating Artery Aneurysm

Cited by 14 publications

References 37 publications

Anatomical variations of the anterior communicating artery complex: gender relationship

Anatomical variations of the anterior communicating artery complex: gender relationship

Anterior Communicating Artery Aneurysms

Enlarged anterior communicating artery masquerading as intracranial aneurysm

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