2022
DOI: 10.1136/bcr-2021-245010
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Lethal subarachnoid haemorrhage in a patient with rete mirabile network of the posterior circulation with associated aneurysm

Abstract: Rete mirabile (RM), an arterial network normally existing in some vertebrate animals interconnecting the extracranial and intracranial arterial circulation, can rarely be found in humans whether asymptomatic or presenting with cerebral ischaemia or haemorrhage. Encompassing diverse angiographic characteristics and similarities with other arterial malformations, proper diagnosis and differential diagnosis is challenging. We hereby describe an unusual RM case variant, presenting to us with lethal subarachnoid ha… Show more

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(4 citation statements)
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“… 5 This process is called “distal annexation.” 8 The pathogenesis of PCA rete formation has been hypothesized to be the incidence of a remnant of distal annexation between the primitive AchA and the PCA during embryogenesis. 2 , 5 To our knowledge, this is the first report of coexisting AchA and PCA retia mirabilia, supporting the remnant of distal annexation between the primitive AchA and the PCA as the underlying pathogenesis of rete formation at this site.…”
supporting
confidence: 58%
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“… 5 This process is called “distal annexation.” 8 The pathogenesis of PCA rete formation has been hypothesized to be the incidence of a remnant of distal annexation between the primitive AchA and the PCA during embryogenesis. 2 , 5 To our knowledge, this is the first report of coexisting AchA and PCA retia mirabilia, supporting the remnant of distal annexation between the primitive AchA and the PCA as the underlying pathogenesis of rete formation at this site.…”
supporting
confidence: 58%
“… 3 , 12–14 With regard to the posterior circulation, retia mirabilia involving the vertebral artery, PCA, and posterior inferior cerebellar artery have been previously reported. 2 , 5–7 , 15 In the two cases of PCA rete mirabile reported earlier, 2 , 5 one was asymptomatic, whereas the patient in the other case died from subarachnoid hemorrhage due to rete mirabile–associated aneurysm. The primitive AchA has cortical branches to the temporal, parietal, and occipital lobes in the early embryonic stage that transform into the P2–4 segments of the PCA distal to the posterior communicating artery.…”
Section: Discussionmentioning
confidence: 96%
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