Variations of the Proximal Anterior Cerebral Artery (ACA), Including Anterior Communicating Artery (ACoA)

Uchino, Akira

doi:10.1007/978-981-16-6803-6_9

Cited by 4 publications

(5 citation statements)

References 24 publications

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“…However, in the case presented here, one ACA was completely supplying both ACAs territories, due to the contralateral agenesis/aplasia of ACA. Unilateral A1 aplasia, such as was encountered here, is frequently observed 16 . It was encountered on magnetic resonance angiograms in 6.7% of cases 17 …”

Section: Discussionsupporting

confidence: 52%

“…Unilateral A1 aplasia, such as was encountered here, is frequently observed. 16 It was encountered on magnetic resonance angiograms in 6.7% of cases. 17 In conclusion, combined morphologies such as in the case reported here could lead to a bilateral anterior circulation supplied from a single internal carotid artery that, in turn, has a BA-"backuped" contribution to the posterior circulation.…”

Section: Discussionmentioning

confidence: 99%

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Bihemispheric Right Anterior Cerebral Artery, Fenestrated Origin of the Left Pericallosal Artery, Fenestrated Basilar Artery, Double Right Posterior Cerebral Artery

Rusu

Lazăr

Vrapciu

2023

Journal of Craniofacial Surgery

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Anatomical variations of the cerebral vasculature are frequently encountered. The archived magnetic resonance angiogram of a 62-year-old male patient was studied anatomically on planar slices and 3-dimensional volume renderings. Numerous anatomical variants were found in that single case. In the vertebrobasilar system were found: the proximal basilar artery fenestration, with a unilateral origin from that fenestration of an anterior inferior cerebellar artery, and the unilateral origin of the superior cerebellar artery from the P1 segment of the main posterior cerebral artery (PCA). There were also unilateral variants of the right internal carotid artery (ICA): a subvariant of an accessory PCA leaving the ICA as a hyperplastic anterior choroidal artery and united to the main PCA by a short communicating branch, distinctive of the posterior communicating artery in that side (unilateral double PCA); a right bihemispheric anterior cerebral artery (ACA) but with complete agenesis of the contralateral A1 ACA segment; from the right ACA continued an anatomically normal ipsilateral A2 segment and a short transverse contralateral A2 that, in turn, sent off long pericallosal and callosomarginal arteries; and fenestrated origin of the left pericallosal artery. Therefore, an arterial variant in one of the main cerebral circulations could not exclude anatomical variants in the other cerebral circulatory beds.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Bihemispheric Right Anterior Cerebral Artery, Fenestrated Origin of the Left Pericallosal Artery, Fenestrated Basilar Artery, Double Right Posterior Cerebral Artery

Rusu

Lazăr

Vrapciu

2023

Journal of Craniofacial Surgery

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“…Treatment strategies have evolved over the years to provide optimal outcomes. However, aside from the patient’s clinical condition, aneurysm’s morphology, and clinical settings, there are particular challenges with approaching these entities, one of which represents the associated anatomical variations of brain vessels [ 3 , 6 , 8 ]. Critically important is the recognition of anatomical variations in the ACA–ACoA complex to avoid ischemic and detrimental clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Microsurgery for brain aneurysms in an accessory A2 and basilar arteries: a rare case presentation and surgical video

Bocanegra-Becerra,

Acha Sánchez,

Contreras Montenegro

2024

Journal of Surgical Case Reports

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We present the case of a 58-year-old male with a 3-day history of sudden onset headache, loss of consciousness, and uncontrolled vomiting. The patient had 3/5 quadriparesis and a Glasgow coma scale (GCS) score of 8, which merited neurocritical intensive care. Brain imaging suggested the presence of two lesions: (i) a fusiform aneurysm of 12 × 7 mm in an accessory A2 artery of the anterior cerebral artery and (ii) an unruptured saccular aneurysm of 3.3 × 2.8 mm in the distal segment of the basilar artery. He was deemed a candidate for microsurgical management. Postoperatively, he had 4/5 quadriparesis, paresis of the right oculomotor nerve, and a GCS score of 13. A 3-month follow-up showed a significant improvement in neurological function with a score of 2 on the modified Rankin scale. The presented case illustrates the relevance of a nuanced acquaintance to operate in diseased anatomical variants and complex pathologies of narrow corridors.

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“…These authors described "a wide variety in fenestrations of the AComA from simple duplication to stepladder-like configurations" without distinguishing between fenestrations and duplications. Later, duplications of AComA were classified by Uchino (2022) as complete (two parallel arms uniting the ACAs), partial (the two arms insert distinctively into one ACA and by a common trunk into the opposite one), and double partial (the two AComAs draw a lying X between the ACAs) [ 18 ]. AComA duplication is estimated at a 4.3% pooled prevalence [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Multiple Rare Anatomic Variations in Anterior and Posterior Cerebral Circulation: A Case Report

Rusu,

Lazăr,

Vrapciu

et al. 2024

Cureus

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Anatomic variations of intracranial arteries are of paramount importance in neurosurgery and interventional radiology. Three extremely rare arterial variants were found by observing the intracranial vascular anatomy on the magnetic resonance angiography files of a 56-year-old female patient. Firstly, on the left side of the vertebrobasilar axis, a persistent primitive lateral basilovertebral anastomosis was found uniting the left anterior inferior and posterior inferior cerebellar arteries; further, the left anterior inferior cerebellar artery looped above the nerves of the internal auditory canal. Secondly, the right posterior inferior cerebellar artery was shown to be leaving the vertebral artery and had a distal fenestration of the telovelotonsillar segment. Such cases of distal fenestrated posterior inferior cerebellar artery are rare. Thirdly, a partly duplicated anterior communicating artery was also found in the anterior circulation. In conclusion, magnetic resonance angiography helps distinguish and detail discrete and delicate rare arterial variants.

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Variations of the Proximal Anterior Cerebral Artery (ACA), Including Anterior Communicating Artery (ACoA)

Cited by 4 publications

References 24 publications

Bihemispheric Right Anterior Cerebral Artery, Fenestrated Origin of the Left Pericallosal Artery, Fenestrated Basilar Artery, Double Right Posterior Cerebral Artery

Bihemispheric Right Anterior Cerebral Artery, Fenestrated Origin of the Left Pericallosal Artery, Fenestrated Basilar Artery, Double Right Posterior Cerebral Artery

Microsurgery for brain aneurysms in an accessory A2 and basilar arteries: a rare case presentation and surgical video

Multiple Rare Anatomic Variations in Anterior and Posterior Cerebral Circulation: A Case Report

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