nach oben

Erschienen in:

16.06.2021 | Original Article

An MRI study of typical anatomical variants of the anterior communicating artery complex

verfasst von: Fabien Fredon, Maxime Baudouin, Jeremy Hardy, Assia Kouirira, Léa Jamilloux, Abdelkader Taïbi, Christian Mabit, Denis Valleix, Aymeric Rouchaud, Sylvaine Durand-Fontanier

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 12/2021

Einloggen, um Zugang zu erhalten

Abstract

Purpose

This magnetic resonance imaging study examined the most frequent anatomical variants of the anterior communicating artery (ACoA) complex of the cerebral arterial circle, and aimed to determine whether they were associated with ACoA complex aneurysm.

Methods

The study enrolled 669 patients. Using three-dimensional time-of-flight magnetic resonance angiography, 617 patients were classified into the following groups based on the anatomical variation in the ACoA complex: no ACoA complex anomaly; ACoA complex aneurysm; and vascular anomaly distant from the cerebral arterial circle.

Results

Of the 617 classified subjects, the classical anatomical description applied to 48.73% in the no ACoA complex anomaly group and 37.5% in the ACoA complex aneurysm group. One variant (left anterior cerebral artery segment A1 hypoplasia) was significantly more frequent in the ACoA complex aneurysm group. There was no sex difference in the prevalence of any variant.

Conclusions

Anatomical variants of the ACoA complex of the cerebral arterial circle were found in almost half of the subjects. One variant seemed to be associated with a higher likelihood of an aneurysm, but causality could not be inferred.

Ahlqvist J (2001) Stress-related intracerebral hemorrhage and the water-hammer effect. Stroke 32:275–278. https://doi.org/10.1161/01.STR.32.1.275-aCrossRefPubMed

Damşa T, Appel E, Cristidis V (1976) “Blood-hammer” phenomenon in cerebral hemodynamics. Math Biosci 29:193–202. https://doi.org/10.1016/0025-5564(76)90102-4CrossRef

Ding R, Xu X, Guan D, Zhu B, Zhang G, Wu X (2019) Fatal subarachnoid hemorrhage caused by rupture of variant anterior communicating artery: a case report and literature review. Forensic Sci Med Pathol 15:97–101. https://doi.org/10.1007/s12024-018-0042-3CrossRefPubMed

Hannequin P, Peltier J, Destrieux C, Velut S, Havet E, Le Gars D (2013) The inter-optic course of a unique precommunicating anterior cerebral artery with aberrant origin of an ophthalmic artery: an anatomic case report. Surg Radiol Anat 35:269–271. https://doi.org/10.1007/s00276-012-1028-6CrossRefPubMed

Iqbal S (2013) A comprehensive study of the anatomical variations of the circle of willis in adult human brains. J Clin Diagn Res 7:2423–2427. https://doi.org/10.7860/JCDR/2013/6580.3563CrossRefPubMedPubMedCentral

Jiménez-Sosa M, Cantu-Gonzalez J, Morales-Avalos R, Garza-Castro O, Quiroga-Garza A, Pinales-Razo R, Elizondo G, Elizondo Omaña R, López S (2017) Anatomical variants of anterior cerebral arterial circle: a study by multidetector computerized 3D tomographic angiography. Int J Morphol 35:1121–1128. https://doi.org/10.4067/S0717-95022017000300049CrossRef

Kamath S (1981) Observations on the length and diameter of vessels forming the circle of Willis. J Anat 133:419–423PubMedPubMedCentral

Kawashima M, Endo M, Kitahara T, Soma K, Fujii K (2008) Unusual location of anterior communicating artery aneurysm located on the planum sphenoidale due to long A1 segments. Neurol Med Chir (Tokyo) 48:254–256. https://doi.org/10.2176/nmc.48.254CrossRef

Kayembe KN, Sasahara M, Hazama F (1984) Cerebral aneurysms and variations in the circle of Willis. Stroke 15:846–850. https://doi.org/10.1161/01.str.15.5.846CrossRefPubMed

10.

Kim MS, Sim SY (2016) Infraoptic anterior cerebral artery: case series report and literature review. Surg Radiol Anat 38:887–891. https://doi.org/10.1007/s00276-016-1651-8CrossRefPubMed

11.

Krabbe-Hartkamp MJ, van der Grond J, de Leeuw FE, de Groot JC, Algra A, Hillen B, Breteler MM, Mali WP (1998) Circle of Willis: morphologic variation on three-dimensional time-of-flight MR angiograms. Radiology 207:103–111. https://doi.org/10.1148/radiology.207.1.9530305CrossRefPubMed

12.

Krzyzewski RM, Tomaszewska IM, Lorenc N, Kochana M, Goncerz G, Klimek-Piotrowska W, Walocha K, Urbanik A (2014) Variations of the anterior communicating artery complex and occurrence of anterior communicating artery aneurysm: A2 segment consideration. Folia Med Cracov 54:13–20PubMed

13.

Krzyżewski RM, Tomaszewski KA, Kochana M, Kopeć M, Klimek-Piotrowska W, Walocha JA (2015) Anatomical variations of the anterior communicating artery complex: gender relationship. Surg Radiol Anat 37:81–86. https://doi.org/10.1007/s00276-014-1313-7CrossRefPubMed

14.

Leipzig TJ, Morgan J, Horner TG, Payner T, Redelman K, Johnson CS (2005) Analysis of intraoperative rupture in the surgical treatment of 1694 saccular aneurysms. Neurosurgery 56:455–468. https://doi.org/10.1227/01.neu.0000154697.75300.c2 (discussion 455-468)CrossRefPubMed

15.

López-Sala P, Alberdi N, Mendigaña M, Bacaicoa M-C, Cabada T (2020) Anatomical variants of anterior communicating artery complex. A study by Computerized Tomographic Angiography. J Clin Neurosci 80:182–187. https://doi.org/10.1016/j.jocn.2020.08.019CrossRefPubMed

16.

Mahajan A, Banga V, Chatterjee A, Goel G (2020) Infraoptic course of anterior cerebral artery coexistence with double fenestration of proximal A2 segment of anterior cerebral artery with associated dysplastic anterior communicating artery aneurysm treated with stent-assisted coiling. Asian J Neurosurg 15:247–249. https://doi.org/10.4103/ajns.AJNS_193_19CrossRefPubMedPubMedCentral

17.

Makowicz G, Poniatowska R, Lusawa M (2013) Variants of cerebral arteries—anterior circulation. Pol J Radiol 78:42–47. https://doi.org/10.12659/PJR.889403CrossRefPubMedPubMedCentral

18.

Meyer A, Hierons R (1964) A note on Thomas Willis’ views on the corpus striatum and the internal capsule. J Neurol Sci 1:547–554. https://doi.org/10.1016/0022-510X(64)90172-8CrossRefPubMed

19.

Ravikanth R, Philip B (2019) Magnetic resonance angiography determined variations in the circle of Willis: analysis of a large series from a single center. Tzu Chi Med J 31:52–59. https://doi.org/10.4103/tcmj.tcmj_167_17CrossRefPubMedCentral

20.

Rengachary SS, Xavier A, Manjila S, Smerdon U, Parker B, Hadwan S, Guthikonda M (2008) The legendary contributions of Thomas Willis (1621–1675): the arterial circle and beyond. J Neurosurg 109:765–775. https://doi.org/10.3171/JNS/2008/109/10/0765CrossRefPubMed

21.

Rinaldo L, McCutcheon BA, Murphy ME, Bydon M, Rabinstein AA, Lanzino G (2017) Relationship of A1 segment hypoplasia to anterior communicating artery aneurysm morphology and risk factors for aneurysm formation. J Neurosurg 127:89–95. https://doi.org/10.3171/2016.7.JNS16736CrossRefPubMed

22.

Rossitti S (2015) Letter to the Editor: the blood-hammer effect and aneurysmal basilar artery bifurcation angles. J Neurosurg 122:1512–1513. https://doi.org/10.3171/2014.12.JNS142667CrossRefPubMed

23.

Sun L, Wang J, Li M, Li M, Zhu Y (2020) The contribution of wall shear stress insult to the growth of small unruptured cerebral aneurysms in longitudinal 3D-TOF-MRA. J Neurol Sci 413:116798. https://doi.org/10.1016/j.jns.2020.116798CrossRefPubMed

24.

Tarulli E, Fox AJ (2010) Potent risk factor for aneurysm formation: termination aneurysms of the anterior communicating artery and detection of A1 vessel asymmetry by flow dilution. AJNR Am J Neuroradiol 31:1186–1191. https://doi.org/10.3174/ajnr.A2065CrossRefPubMedPubMedCentral

25.

Turkoglu E, Arat A, Patel N, Kertmen H, Başkaya MK (2011) Anterior communicating artery aneurysm associated with an infraoptic course of anterior cerebral artery and rare variant of the persistent trigeminal artery: a case report and literature review. Clin Neurol Neurosurg 113:335–340. https://doi.org/10.1016/j.clineuro.2010.12.009CrossRefPubMed

26.

Uchino A, Nomiyama K, Takase Y, Kudo S (2006) Anterior cerebral artery variations detected by MR angiography. Neuroradiology 48:647–652. https://doi.org/10.1007/s00234-006-0110-3CrossRefPubMed

27.

Zhang X, Karuna T, Yao Z-Q, Duan C-Z, Wang X-M, Jiang S-T, Li X-F, Yin J-H, He X-Y, Guo S-Q, Chen Y-C, Liu W-C, Li R, Fan H-Y (2018) High wall shear stress beyond a certain range in the parent artery could predict the risk of anterior communicating artery aneurysm rupture at follow-up. J Neurosurg 131:868–875. https://doi.org/10.3171/2018.4.JNS173179CrossRefPubMed

28.

Zhao H, Fu J, Lu Z, Lü H (2009) Fenestration of the anterior cerebral artery detected by magnetic resonance angiography. Chin Med J (Engl) 122:1139–1142

29.

Zurada A, Gielecki J, Tubbs RS, Loukas M, Maksymowicz W, Chlebiej M, Cohen-Gadol AA, Zawiliński J, Nowak D, Michalak M (2011) Detailed 3D-morphometry of the anterior communicating artery: potential clinical and neurosurgical implications. Surg Radiol Anat 33:531–538. https://doi.org/10.1007/s00276-011-0792-zCrossRefPubMed

Titel: An MRI study of typical anatomical variants of the anterior communicating artery complex
verfasst von: Fabien Fredon
Maxime Baudouin
Jeremy Hardy
Assia Kouirira
Léa Jamilloux
Abdelkader Taïbi
Christian Mabit
Denis Valleix
Aymeric Rouchaud
Sylvaine Durand-Fontanier
Publikationsdatum: 16.06.2021
Verlag: Springer Paris
Erschienen in: Surgical and Radiologic Anatomy / Ausgabe 12/2021
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-021-02782-x

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

An MRI study of typical anatomical variants of the anterior communicating artery complex