Fenestration of the Intracranial Internal Carotid Artery

Abstract

A rare case of fenestration of the intracranial internal carotid artery (ICA) was identified by angiography in a 51-year-old female with suspected subarachnoid hemorrhage. Only two similar cases have been reported previously. Fenestration tends to develop on the right side and near the bifurcation of the ophthalmic artery. Congenital factors at the 4 mm embryonic stage may be involved in the fenestration of the intracranial ICA.

Fenestration of the Supraclinoid Internal Carotid Artery With Associated Aneurysm -Case Report-

“…The fenestration began proximal to the bifurcation of the ophthalmic artery from the ICA in all cases. The fenestration ended at the bifurcation of the PCoA from the ICA in six cases 1,5,8,10,12) and the anterior choroidal artery from the ICA in one case. 4) Subarachnoid hemorrhage occurred in five patients, 1,4,5,8,12) due to rupture of the aneurysm located in the fenestrated segment in three, 1,8,12) and to rupture of anterior communicating artery and middle cerebral artery aneurysms in one each.…”

“…The cervical common carotid artery was exposed to maintain proximal blood flow control, and left frontotemporal craniotomy was 4) 28, F rt between the ophA and AChA ＋ ＋ Takano et al (1991) 10) 51, F rt between the ophA and PCoA --Banach and Flamm (1993) 1) 37, F lt between the ophA and PCoA ＋ ＋ clip Katsuta et al (1993) 5) 47, F rt between the ophA and PCoA ＋ -Ng et al (2006) 8) 34 Fenestration of ICA performed. The left ICA was confirmed, but the aneurysm was not identified ( Fig.…”

“…Table 1 summarizes the previous and present cases of fenestration of the intracranial ICA. 1,4,5,8,10,12) The patients were all females aged 28 to 51 years (mean 39.9 years). The fenestration was on the right in five patients and the left in two.…”

“…1,4,5,8,10,12) Three of these cases were associated with aneurysms arising from the proximal portion of the fenestration. 1,8,12) Here, we report a case of fenestration of the left supraclinoid ICA with an associated aneurysm at the proximal end of the fenestration.…”

Fusiform Aneurysm Associated With Fenestration of the Posterior Communicating Artery -Case Report-

“…[1][2][3][5][6][7][8][10][11][12][13] We describe an extremely rare case of a fenestration that possibly consists of a double origin of the PCoA with an associated fusiform aneurysm.…”