Three‐dimensional morphometrical analysis of the M1 segment of the middle cerebral artery: Potential clinical and neurosurgical implications

Żurada, Anna; Gielecki, Jerzy; Tubbs, R. Shane; Loukas, Marios; Maksymowicz, Wojciech; Cohen-Gadol, Aaron; Michalak, Maciej; Chlebiej, Michał; Żurada-Zielińska, Agnieszka

doi:10.1002/ca.21051

Cited by 22 publications

(12 citation statements)

References 34 publications

(69 reference statements)

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“…We performed these analyses on a large sample of healthy human subjects and tested effects of age, gender and hemispheric lateralization on the main arterial tree. Earlier imaging data based upon hemodynamic response of blood vessels provided useful information on vascular anatomy, including arterial bifurcations (Fanucci et al, 1988, 1990; Rossitti and Lofgren, 1993b; Karch et al, 2000; Zurada et al, 2010, 2011) and branch tapering (MacLean et al, 1992; Roach and MacLean, 1993). However, these studies were limited in the number of subjects, completeness of the reconstruction, or detail of the quantitative analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Age-related changes, hemispheric lateralization, and gender-related difference in cerebral circulation may all be important risk factors in cerebrovascular disorders (Zanatta et al, 2012; Zurada et al, 2011). For instance, increase in tortuosity of right arterial trees during normal aging may have clinical implications (Zurada et al, 2010, 2011), while higher rate of subarachnoid hemorrhages in women may be caused by hormonal differences (Ghods et al, 2012). …”

Section: Introductionmentioning

confidence: 99%

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Digital reconstruction and morphometric analysis of human brain arterial vasculature from magnetic resonance angiography

et al. 2013

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Characterization of the complex branching architecture of cerebral arteries across a representative sample of the human population is important for diagnosing, analyzing, and predicting pathological states. Brain arterial vasculature can be visualized by magnetic resonance angiography (MRA). However, most MRA studies are limited to qualitative assessments, partial morphometric analyses, individual (or small numbers of) subjects, proprietary datasets, or combinations of the above limitations. Neuroinformatics tools, developed for neuronal arbor analysis, were used to quantify vascular morphology from 3 T time-of-flight MRA high-resolution (620 μm isotropic) images collected in 61 healthy volunteers (36/25 F/M, average age = 31.2 ± 10.7, range = 19–64 years). We present in-depth morphometric analyses of the global and local anatomical features of these arbors. The overall structure and size of the vasculature did not significantly differ across genders, ages, or hemispheres. The total length of the three major arterial trees stemming from the circle of Willis (from smallest to largest: the posterior, anterior, and middle cerebral arteries; or PCAs, ACAs, and MCAs, respectively) followed an approximate 1:2:4 proportion. Arterial size co-varied across individuals: subjects with one artery longer than average tended to have all other arteries also longer than average. There was no net right–left difference across the population in any of the individual arteries, but ACAs were more lateralized than MCAs. MCAs, ACAs, and PCAs had similar branch-level properties such as bifurcation angles. Throughout the arterial vasculature, there were considerable differences between branch types: bifurcating branches were significantly shorter and straighter than terminating branches. Furthermore, the length and meandering of bifurcating branches increased with age and with path distance from the circle of Willis. All reconstructions are freely distributed through a public database to enable additional analyses and modeling (cng.gmu.edu/brava).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Digital reconstruction and morphometric analysis of human brain arterial vasculature from magnetic resonance angiography

et al. 2013

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“…We studied the M1 segment of the ACM in 50 arteries. This segment was in most cases arch-shaped, in 32 (64%) artery (I), rarely in S-shaped, in 12 (24%) artery (II), whereas much less frequently it had straight alignment, in 6 (12%) of arteries (III) ( According to the other authors data [12,14], the average length of this segment was 15.4 mm, respectively 15.5mm. On the other hand, Yasargil [3] emphasized the extension of 0 mm to 30 mm length.…”

Section: Resultsmentioning

confidence: 77%

“…Measurements in native preparations as well as blood vessels in angiography could not be more accurate than our data. Other authors [13][14][15] also do not provide data on the forms of the M1 segment, and also in the literature there is no data on the size of different morphological types of the M1 segment.…”

Section: 6mm (Table 2) (Graph 3)mentioning

confidence: 99%

Variations of shape, length, branching, and end trunks of M1 segment of middle cerebral artery

Reçi¹,

Bexheti²

2019

J Neurol Neurol Sci Disord

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Introduction: The middle cerebral artery is divided into four segments: proximal M1, insular M2, opercular M3 and cortical M4. M1 extends from the bifurcation point of ACI at ACA and ACM to the insula threshold, laterally from chiasma opticum, laterally from tractus opticus and caudally from trigonum olfactorium, directed laterally, dorsally and rostrally. Early division of the M1 segment into the fi nal trunk is possible at any of the fi rst points of the limb insulae. Material and methods: The study of the micromorphological and morphometric characteristics of the M1 segment was performed in 25 brain (50 ACM preparations) obtained from autopsy of both sexes of different ages without pathological changes. For the removal of the brain from the skull we used the usual technique of obduction. Results: This segment was arch-shaped, in 32 (64%) arteries, rarely S-shaped, in 12 (24%) arteries, much less straight alignment, in 6 (12%) arteries. The average length of the M1 segment of the S shape was 20.6±3.31mm, with a 19.8mm 4.41mm arch shape, while the straight shape was 16.9±3.62mm. The average S-shaped diameter was 2.7±0.51mm, arched 2.6±0.47mm, straight form 2.6±0.36mm. Variations of M1 branching were: common in 38 cases, early branching in 12 cases, joint trunk with cortical branch in 9 cases, lateral cortical branch in 21 cases, fi nal bifurcation in 24 cases, fi nal trifurcation in 13 cases, duplication in 1 case and M1 accessory in just 1 case. Conclusion: True bifurcation refers to the division of the M1 segment into two fi nal trunks. In cases where the strong joint cortical branch trunk divides from segment M1, while dividing into two terminal trunk immediately after ACM knee formation, it is described as false branching of M1 segment into three terminal branches.

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“…In some instances, utilization of the STA-MCA bypass techniques 18 , ultrasound flow probe measurement of branch flow patency 19,20,21 , and adequate neurosurgical technique with proper temporary clipping application, will decrease morbidity and mortality associated with microsurgical approaches for middle cerebral artery aneurysms. The improvement in imaging technology permits adequate study of the vascular anatomy of the patients, directions of the vessels and detailed assessment of the three-dimensional morphology expected intra-operatively 22 .…”

Section: Discussionmentioning

confidence: 99%

Middle cerebral artery aneurysms: aneurysm angiographic morphology and its relation to pre-operative and intra-operative rupture

Estevão

Camporeze

Araújo³

et al. 2017

Arq. Neuro-Psiquiatr.

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ARTICLEMiddle cerebral artery aneurysms: aneurysm angiographic morphology and its relation to pre-operative and intra-operative rupture Aneurismas da artéria cerebral média: morfologia angiográfica dos aneurismas e sua relação com ruptura pré-operatória e intra-operatória ABSTRACTObjective: Correlate the middle cerebral artery bifurcation aneurysm morphology with the pre-operative and intra-operative risk of rupture. Methods: Forty patients with 46 middle cerebral artery bifurcation aneurysms were treated microsurgically by the same surgeon. Aneurysms were classified according to shape and the Fisher test was applied to analyze the effect of morphology on the pre-operative and intra-operative rupture. Results: Pre-operative and intra-operative ruptures were observed in 8/46 patients (17.4%) and 14/46 patients (30.4%) respectively. Thirty-two cases (69.6%) had no symptoms postoperatively, modified Rankin score (MRS) of 0; 6.5% had MRS of 1 (no significant disability); 13% had MRS of 2 (slight disability); 4.3% had moderately severe disability (MRS of 4); and there were 3 deaths (6.5%) post-operatively. The morphology was not directly related to the rupture rate. Conclusion: In general, ruptures are not affected by the morphology or the studied variables. Larger series are needed to validate these outcomes.Keywords: aneurysm; subarachnoid hemorrhage; middle cerebral artery. RESUMOObjetivo: Correlacionar a morfologia do aneurisma da bifurcação da artéria cerebral média com o risco de ruptura pré-operatória e intraoperatória. Métodos: 40 pacientes com 46 aneurismas de bifurcação da artéria cerebral média receberam tratamento microcirúrgico pelo mesmo cirurgião. Os aneurismas foram classificados de acordo com a morfologia e o teste de Fisher foi aplicado para analisar o efeito da morfologia sobre a ruptura pré-operatória e intra-operatória. Resultados: As rupturas pré e intra-operatória foram observadas em 8/46 pacientes (17,4%) e 14/46 (30,4%) respectivamente. Trinta e dois casos (69,6%) não apresentaram sintomas pós-operatórios, pontuação de Rankin modificada (MRS) de 0, 6,5% tinham MRS de 1 (sem incapacidade significativa), 13% tinham MRS de 2 (leve incapacidade), 4,3% moderadamente grave (MRS de 4) e houve 3 óbitos (6,5%) durante o pós-operatório. A morfologia não estava diretamente relacionada à taxa de ruptura pré-operatória ou intra-operatória. Conclusão: Em geral, as rupturas não são afetadas pela morfologia ou pelas variáveis estudadas. São necessárias séries maiores para validar esses resultados.Palavras-chave: aneurisma; hemorragia subaracnoidea; artéria cerebral média.

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Three‐dimensional morphometrical analysis of the M1 segment of the middle cerebral artery: Potential clinical and neurosurgical implications

Cited by 22 publications

References 34 publications

Digital reconstruction and morphometric analysis of human brain arterial vasculature from magnetic resonance angiography

Digital reconstruction and morphometric analysis of human brain arterial vasculature from magnetic resonance angiography

Variations of shape, length, branching, and end trunks of M1 segment of middle cerebral artery

Middle cerebral artery aneurysms: aneurysm angiographic morphology and its relation to pre-operative and intra-operative rupture

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