Fenestrations of the human posterior cerebral artery

Vlajković, Slobodan; Vasović, Ljiljana; Trandafilović, Milena; Jovanović, Ivan; Ugrenović, Slađana; Đorđević, Gordana

doi:10.1007/s00381-014-2597-y

Cited by 9 publications

(12 citation statements)

References 19 publications

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“…In a review of the literature, there are multiple variations of the PCA such as fenestration, early bifurcation, and duplication. Vlajković, et al examined the PCA of 468 (200 fetal and 268 adults) cadavers, finding four cases (0.85%) of fenestration with two of them being in the P1 segment [ 1 ]. In their study, they surveyed the literature for similar cases of fenestration within the PCA.…”

Section: Discussionmentioning

confidence: 99%

“…While there is some disagreement on the classification of certain segments, all classification systems hold that P1 is from the origin of the PCA to the anastomosis with the posterior communicating artery (PCoA). The P1, also known as the pre-communicating segment, resides within the interpeduncular cistern and gives off the following branches: the posterior thalamoperforating artery, direct perforating artery, long circumflex artery, and short circumflex artery [ 1 - 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Bayrak, et al define a fenestration as “a vascular variation that begins with a common origin, then splits into two parallel luminal channels and rejoins distally" [ 3 ]. There have only been a handful of cases in the literature that describe fenestrations within the P1 segment, and from 1969 to 2014 there were only 19 reported cases [ 1 ]. Since then, researchers have sought to use computed tomography (CT) angiography to identify variations since in the past most have been discovered only through cadaveric dissection [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Fenestration in the P1 Segment of the Posterior Cerebral Artery

Jensen¹,

Shereen²,

Tubbs³

et al. 2017

Cureus

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The posterior cerebral artery (PCA) has been noted in literature to have anatomical variations, specifically fenestration. Cerebral arteries with fenestrations are uncommon, especially when associated with other vascular pathologies. We report a case here of fenestrations within the P1 segment of the right PCA associated with a right middle cerebral artery (MCA) aneurysm in an elder adult male who presented with a new onset of headaches. The patient was treated with vascular clipping of the MCA and has recovered well. Identifying anatomical variations with appropriate imaging is of particular importance in neuro-interventional procedures as it may have an impact on the procedure itself and consequently post-interventional outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fenestration in the P1 Segment of the Posterior Cerebral Artery

Jensen¹,

Shereen²,

Tubbs³

et al. 2017

Cureus

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“…These fenestrations can also be observed in the P2 segment or distal PCA, although this is extremely rare (2, 10,13,21,39,42). While most cases of PCA fenestration are reported as case reports (21,24,44,46,55), the prevalence has been reported to be between 0.01% and 1.4% (Table IV) (2, 10,12,19,23,29,37,47,51,52).…”

Section: Fenestrationmentioning

confidence: 95%

Variation and anomalies of the posterior cerebral artery: review and pilot study

Cilliers

Page²

2017

Turkish Neurosurgery

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Variations and anomalies of the posterior cerebral artery (PCA) have several clinical implications, including assisting in understanding the clinical signs of a stroke. Anomalies have been described previously; however, few reports mention the origins, absence, duplication and triplication of the cortical branches. Furthermore, the PCA branching pattern has not been adequately described. The aim of this study is to describe the anatomy and anomalies of the PCA. Results of a pilot study were additionally included. The quantity, origin, diameter and length of the PCA cortical branches were described in this review, as well as the branching pattern and the anomalies. Accordingly, the pilot study reported on these aspects. In the pilot study it was evident that the description of the branching pattern is not the "normal" pattern, since it was only observed in one case. This pattern was re-evaluated and three groups were described; monofurcation, bifurcation and trifurcation. Furthermore, one case of a fenestration was observed. Aneurysms tend to form at branching points, thus knowledge of the branching pattern can aid in detection of ruptured and un-ruptured aneurysms in this region. This review outlined several gaps in the literature, and a pilot study was included to fill some of these gaps. Future research should especially focus on the branching pattern of the PCA. Possible sex, age and population differences may also exist.

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“…The fenestrations of the cerebral arteries appear in all the branches but are most commonly reported in the vertebrobasilar artery ( 4 ), ACA ( 9 ), MCA ( 10 – 12 ), ACOA ( 13 ), and the posterior cerebral artery ( 14 ). In recent years, more and more people were found to suffer from fenestration, as we all know, the vessels where the fenestration is located will have hemodynamic changes, and whether this will cause the occurrence of other diseases is still unknown.…”

Section: Introductionmentioning

confidence: 99%

Retrospective analysis of image characteristics of 76 cases of cerebral vascular fenestrations

Chen

Wang

et al. 2022

Front. Neurol.

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ObjectivesThis study aims to summarize the clinical and imaging features of cerebral vascular fenestration and to explore the association between cerebral vascular fenestration and cerebral infarction and aneurysm.Materials and methodsThe computed tomography angiography (CTA), magnetic resonance angiography (MRA), and digital subtraction angiography (DSA) imaging data of 76 cases of cerebral vascular fenestration from January 2021 and December 2021 in the Yantai Yuhuangding Hospital Affiliated to Qingdao University were analyzed. The general information was described. The location, morphology, and size of cerebral vascular fenestration were described. The association between cerebral vascular fenestration and infarction and aneurysm was analyzed.ResultsAmong 76 patients, a total of 80 fenestrations were detected (two patients had three fenestrations), and basilar artery fenestration was the most common (28/80). The fenestration <5 mm was 43/80, 5–10 mm was 12/80, and ≥10 mm was 25/80. Moreover, 19 patients had other vascular diseases: 10 with aneurysms, 5 with moyamoya diseases, and 4 with cerebral artery dissections. Except for one aneurysm at the site of the fenestration, other aneurysms were separate from the fenestrations. In addition, 37 patients had cerebral infarctions, of which 16 had cerebral infarctions in the blood supply area of the arterial fenestration. Among these 16 patients, there was more cerebral infarction in posterior circulation than in anterior circulation. However, no statistically significant differences were detected in the risk factors between the fenestration-relevant cerebral infarctions group and the non-fenestration-relevant cerebral infarctions group.ConclusionIn our study, cerebral vascular fenestration occurred most frequently in the basilar artery and may be combined with other vascular diseases. Fenestration in posterior circulation may be related to cerebrovascular diseases. Nonetheless, no clear clinical relevance was observed between fenestration and cerebral infarction. Also, we did not find a definite association between fenestration and aneurysm. For fenestration patients with cerebral infarctions, long-term antiplatelet and statin therapy may be safe and effective.

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Fenestrations of the human posterior cerebral artery

Abstract: The frequency, segment, and side location, as well as the size and shape of PCA fenestrations in specimens of our population did not significantly differ from the same in other populations. PCA fenestrations in our adult specimens were not the bases of aneurysms.

Cited by 9 publications

References 19 publications

Fenestration in the P1 Segment of the Posterior Cerebral Artery

Fenestration in the P1 Segment of the Posterior Cerebral Artery

Variation and anomalies of the posterior cerebral artery: review and pilot study

Retrospective analysis of image characteristics of 76 cases of cerebral vascular fenestrations

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