Fenestration of the middle cerebral artery with an associated ruptured aneurysm

Nussbaum, Eric S.; Defillo, Archie; Janjua, Tariq; Nussbaum, Leslie A.

doi:10.1016/j.jocn.2008.08.039

Cited by 14 publications

(13 citation statements)

References 15 publications

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“…[7] Furthermore, CTA enables better visualization of small vessels and vascular variations. [8] Anatomical variations of the middle cerebral artery were not found seen frequently in our study. An accessory MCA was observed in 0.93% of the patients and the frequency of accessory MCA is reported as 0.3% to 4%.…”

Section: Discussioncontrasting

confidence: 42%

Anatomical variations of the circle of Willis: evaluation with CT angiography

Şahin¹,

Pekçevik²

2018

Anatomy

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Objectives: The aim of this study was to investigate anatomic variants and anomalies of the circle of Willis using computed tomography angiography (CTA). Methods: CTA images of 770 patients obtained from Tepecik Training and Research Hospital between January 2012 to January 2017 were retrospectively reviewed to identify the anatomical vascular variations of the circle of Willis. Results: After exclusion, 751 patients (348 females, 403 males, mean age 54.6 years, range 18-90 years) were enrolled into the study. The anatomical variations related to the posterior communicating artery (PcoA) were the most common, whereas anatomical variations related to the middle cerebral artery (MCA) were the least common variations among arteries. Hypoplasia of the A1 segment was the most common (14.6%) variation of the anterior cerebral artery (ACA) and fenestration of this artery was the least common variation (1,06%) observed only in A1 segment. Bilateral absence of the PcoA was seen in 27.56% of the patients. Fenestration was more commonly detected in anterior communicating artery (AcoA) (10.12%), followed by MCA (1.06%), ACA (1,06%) and PCA (0.67%). Duplication was the least common variation which was detected in MCA, AcoA and PcoA. Conclusion: Arterial variations of the circle of Willis are not rare and can be non-invasively evaluated using CTA.

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Section: Discussioncontrasting

confidence: 42%

Anatomical variations of the circle of Willis: evaluation with CT angiography

Şahin¹,

Pekçevik²

2018

Anatomy

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“…It is rare to see aneurysms at the proximal end of the fenestration [5]. There has been only one reported case of ruptured aneurysm at this fenestration [6]. …”

Section: Discussionmentioning

confidence: 99%

Ruptured aneurysm at the fenestration of the middle cerebral artery detected by magnetic resonance angiography in a patient with systemic lupus erythematosus and renal failure: a case report

Tabuchi

Yoshioka

2014

J Med Case Reports

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IntroductionA cerebral aneurysm arising at the fenestration of the middle cerebral artery is extremely rare, with one report describing subarachnoid hemorrhage due to this type of lesion. There have been no reports of this type of lesion occurring in a patient with systemic lupus erythematosus.Case presentationA 47-year-old Japanese woman with 23 years’ history of systemic lupus erythematosus and chronic renal failure had sudden onset of subarachnoid hemorrhage. We avoided using contrast medium due to her chronic renal failure. Magnetic resonance angiography showed her ruptured aneurysm arising at the site of fenestration of her middle cerebral artery. Successful clipping, perioperative management avoiding the cerebral vasospasm, renal dialysis initiated after the acute phase and placement of a ventriculoperitoneal shunt were performed, and she was discharged home with no complications.ConclusionsThis is the first report of ruptured aneurysm associated with middle cerebral artery fenestration in a patient with systemic lupus erythematosus as detected by magnetic resonance angiography. The presence and anatomical relationship of fenestration accompanied by aneurysm could be noninvasively and accurately evaluated preoperatively using three-dimensional time-of-flight magnetic resonance angiography with the volume rendering method in a case in which contrast medium was contraindicated.

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“…Most of previous articles on the MCA fenestration focused on the association of cerebral aneurysm located at the site of fenestration or distant site from it. In the review of previous reports, 19 cases were coincided with cerebral aneurysms 1,5,7,[12][13][14][15][16][17][18][19]24,29,30,33) and 6 cases of aneurysm developed at the proximal or distal end of fenestration 5,12,18,19,24,30) . Other data indicated that the MCA fenestration was developed mainly at the M1 portion and there was no ethnic predilection between Asian and Western countries.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Aneurysm in the Long Fenestration at the Middle Portion of M1 Segment

Sim

Lee

Park

et al. 2010

J Korean Neurosurg Soc

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J Korean Neurosurg Soc 48 : [434][435][436][437] 2010 We report a unique case of bilateral mirror image M1 aneurysms, one of which was an unruptured aneurysm arising from the proximal end of right middle cerebral artery fenestration with long loop and the other ruptured aneurysm from the contralateral side. We clipped ruptured aneurysm first and unruptured one in three months after the first operation. The difficulties of identifying this unusual vascular anomaly and possible problems during the surgery of an aneurysm at the site of fenestration are discussed with a review of the literature.

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Fenestration of the middle cerebral artery with an associated ruptured aneurysm

Cited by 14 publications

References 15 publications

Anatomical variations of the circle of Willis: evaluation with CT angiography

Anatomical variations of the circle of Willis: evaluation with CT angiography

Ruptured aneurysm at the fenestration of the middle cerebral artery detected by magnetic resonance angiography in a patient with systemic lupus erythematosus and renal failure: a case report

Cerebral Aneurysm in the Long Fenestration at the Middle Portion of M1 Segment

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