Carotid-anterior cerebral artery anastomosis with an anteromedial course variant diagnosed by magnetic resonance angiography.

IF 1.4 4区医学 Q2 Medicine Surgical and Radiologic Anatomy Pub Date : 2025-03-11 DOI:10.1007/s00276-025-03606-y

Akira Uchino, Kazuo Tokushige

{"title":"Carotid-anterior cerebral artery anastomosis with an anteromedial course variant diagnosed by magnetic resonance angiography.","authors":"Akira Uchino, Kazuo Tokushige","doi":"10.1007/s00276-025-03606-y","DOIUrl":null,"url":null,"abstract":"Purpose: To describe a case of right carotid-anterior cerebral artery (ACA) anastomosis with a unique course in the proximal segment.Methods: A 78-year-old woman with a history of right carotid endarterectomy 2 years prior underwent cranial magnetic resonance (MR) imaging (MRI) and magnetic resonance angiography (MRA) of the head and neck regions separately using a 3.0-Tesla scanner. MRA was performed using a standard 3-dimensional time-of-flight technique.Results: MRA of the intracranial region revealed no pathological lesions. However, a large artery arose from the ophthalmic segment of the right ICA, took an anteromedial course and after making a hairpin turn, continued to the bilateral A2 segments of the ACA. Bilateral A1 segments of the ACA were absent. MRA source images and oblique sagittal reformatted images showed that the anomalous artery was running inferior to the right optic nerve, indicative of carotid-ACA anastomosis or an infraoptic course of the ACA. As some patients have an ipsilateral normal A1 segment, the latter name seems to be inadequate.Conclusion: We encountered a case of right carotid-ACA anastomosis in which the proximal segment had a unique course, ran anteromedially, and made a hairpin turn. This type has not been reported in the relevant English-language literature. Usually, this variation takes a medial course and ascends between the bilateral optic nerves. Careful observation of MRA images, including their source images, is required for the correct diagnosis of this rare variation.","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"91"},"PeriodicalIF":1.4000,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgical and Radiologic Anatomy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00276-025-03606-y","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: To describe a case of right carotid-anterior cerebral artery (ACA) anastomosis with a unique course in the proximal segment.

Methods: A 78-year-old woman with a history of right carotid endarterectomy 2 years prior underwent cranial magnetic resonance (MR) imaging (MRI) and magnetic resonance angiography (MRA) of the head and neck regions separately using a 3.0-Tesla scanner. MRA was performed using a standard 3-dimensional time-of-flight technique.

Results: MRA of the intracranial region revealed no pathological lesions. However, a large artery arose from the ophthalmic segment of the right ICA, took an anteromedial course and after making a hairpin turn, continued to the bilateral A2 segments of the ACA. Bilateral A1 segments of the ACA were absent. MRA source images and oblique sagittal reformatted images showed that the anomalous artery was running inferior to the right optic nerve, indicative of carotid-ACA anastomosis or an infraoptic course of the ACA. As some patients have an ipsilateral normal A1 segment, the latter name seems to be inadequate.

Conclusion: We encountered a case of right carotid-ACA anastomosis in which the proximal segment had a unique course, ran anteromedially, and made a hairpin turn. This type has not been reported in the relevant English-language literature. Usually, this variation takes a medial course and ascends between the bilateral optic nerves. Careful observation of MRA images, including their source images, is required for the correct diagnosis of this rare variation.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

求助全文

约1分钟内获得全文去求助

来源期刊

Surgical and Radiologic Anatomy Medicine-Pathology and Forensic Medicine

CiteScore

2.40

自引率

14.30%

发文量

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.