Republished: Rete mirabile associated with pial arteriovenous fistula: imaging features with literature review

Mondel, Prabath Kumar; Saraf, Rashmi; Limaye, Uday

doi:10.1136/neurintsurg-2016-012939.rep

Cited by 6 publications

(3 citation statements)

References 18 publications

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“…However, true prevalence and what percentage becomes symptomatic are currently unknown. RM has been identified in patients with haemorrhagic or ischaemic manifestations 24 25. In a 2015 review, 34% of the identified RM cases (12/35) presented with SAH,24 the first of which was reported in 1967 26.…”

Section: Discussionmentioning

confidence: 99%

Lethal subarachnoid haemorrhage in a patient with rete mirabile network of the posterior circulation with associated aneurysm

2022

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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 haemorrhage owing to a ruptured small aneurysm associated with the RM network. Angiography disclosed an absent P1 segment of the posterior cerebral artery (PCA) and an RM network anastomosing the basilar apex with the normal distal PCA. Brain death was confirmed on the fifth day after admission and attributed to the severity of subarachnoid haemorrhage (SAH). This is an exceedingly rare case representing an intradural-to-intradural RM anastomosis in a patient presenting with lethal SAH. RM epidemiology, pathophysiology, presentation, angiographic findings and prognosis are reviewed.

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Section: Discussionmentioning

confidence: 99%

Lethal subarachnoid haemorrhage in a patient with rete mirabile network of the posterior circulation with associated aneurysm

2022

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“…The reasons that concomitant cerebrovascular diseases are associated with carotid RM are unclear. Currently, these combinations are thought to arise from congenital embryonic etiologies [11]. Therefore, congenital etiology may also be the reason that carotid RM was associated with a moyamoya-pattern collateral vessels of the PCA in our case.…”

Section: Discussionmentioning

confidence: 72%

Spontaneous recession of a posterior cerebral artery aneurysm concurrent with carotid rete mirabile and moyamoya-pattern collateral vessels: a case report

et al. 2019

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Background Carotid rete mirabile (RM) is a meshwork of multiple, freely intercommunicating arterioles that reconstitute the absent or hypoplastic segments of the internal carotid artery (ICA). Carotid RM has been reported to be associated with cerebrovascular diseases. However, it is rarely associated with moyamoya-pattern collateral vessels in the posterior cerebral artery (PCA) region and aneurysm. Case presentation A 39-year-old woman was admitted complaining of sudden-onset headache, nausea, and vomiting. Further investigation revealed subarachnoid hemorrhage (SAH), carotid RM, a moyamoya collateral pattern in the PCA region, and a pseudoaneurysm in the moyamoya-like vessels. The patient was treated conservatively, recovered well and was discharged 1 week later. Follow-up angiography showed that the aneurysm had disappeared. Conclusions As shown by the present case, we believe that carotid RM could occur in combination with moyamoya-pattern collateral vessels in the PCA region; aneurysms can occur in the moyamoya-like vascular network. Congenital etiology may be the reason for these combinations. Based on our approach in this case, aneurysm located in moyamoya-like vessels can disappear spontaneously after conservative treatment.

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“…A rete mirabile can be associated with a cerebral aneurysm, spinal aneurysm, carotid-cavernous fistula, pial arteriovenous fistula, AVM, vein of Galen aneurysmal malformation, pseudoxanthoma elasticum, PHACE (posterior fossa anomalies, hemangioma, arterial anomalies, cardiac anomalies, and eye anomalies) syndrome, vertebral artery stenosis, and Dieulafoy's ulcer. 3,6,7,12,14,23 Previous reports have shown that a rete mirabile was associated with cerebral aneurysms in 20% of cases. 3 Hemodynamic stress from complex vessel architecture of the rete mirabile may induce flow-related aneurysm formation.…”

Section: Observationsmentioning

confidence: 98%

Coexistence of anterior choroidal artery and posterior cerebral artery retia mirabilia presenting with subarachnoid hemorrhage: illustrative case

Yamaguchi,

Kanematsu,

Shimada

et al. 2024

Journal of Neurosurgery: Case Lessons

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BACKGROUND A rete mirabile is a rare vascular anomaly, with posterior cerebral artery (PCA) involvement being especially rare. Its pathogenesis has been speculated as a remnant of “distal annexation” between the primitive anterior choroidal artery (AchA) and the PCA at this site, but the exact mechanisms remain unclear. OBSERVATIONS A 29-year-old man presented with subarachnoid hemorrhage. Arteriovenous malformation in the medial temporal lobe was initially suspected, but an arteriovenous shunt was not detected. First, conservative treatment was administered; however, rebleeding occurred 1 month later. Carotid angiography revealed a network-like cluster of blood vessels at the choroidal point of the AchA, suggesting a rete mirabile; these vessel clusters led to the persistent temporo-occipital branch of the AchA. Furthermore, an aneurysm was detected at the junction between the rete mirabile and the persistent temporo-occipital branch of the AchA. Additionally, vertebral angiography demonstrated a rete mirabile at the P2 segment. These findings suggested the coexistence of AchA and PCA retia mirabilia. Consequently, the aneurysm was clipped using a subtemporal approach to prevent re-rupture, and the postoperative course was uneventful. LESSONS This first report of coexisting AchA and PCA retia mirabilia supports the remnant of distal annexation between the primitive AchA and the PCA as the reason for rete formation at this site.

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Republished: Rete mirabile associated with pial arteriovenous fistula: imaging features with literature review

Cited by 6 publications

References 18 publications

Lethal subarachnoid haemorrhage in a patient with rete mirabile network of the posterior circulation with associated aneurysm

Lethal subarachnoid haemorrhage in a patient with rete mirabile network of the posterior circulation with associated aneurysm

Spontaneous recession of a posterior cerebral artery aneurysm concurrent with carotid rete mirabile and moyamoya-pattern collateral vessels: a case report

Coexistence of anterior choroidal artery and posterior cerebral artery retia mirabilia presenting with subarachnoid hemorrhage: illustrative case

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