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

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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.

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颈动脉-大脑前动脉吻合伴前内侧病变的磁共振血管造影诊断。

目的：报告一例右颈动脉-大脑前动脉（ACA）近段吻合，吻合过程独特。方法：78岁女性，2年前曾行右颈动脉内膜切除术，采用3.0特斯拉扫描仪分别对头部和颈部区域进行MRI和MRA扫描。MRA使用标准的三维飞行时间技术进行。结果：颅内区域MRA未见病理改变。然而，一条大动脉起源于右侧小动脉眼段，走前内侧路线，经过一个发夹弯后，继续延伸到双侧小动脉A2段。双侧A1节段ACA缺失。MRA源图像和斜矢状面重构图像显示异常动脉在右侧视神经下方，提示颈动脉-ACA吻合或ACA的视下走行。由于一些患者有同侧正常的A1节段，后者的名称似乎是不充分的。结论：我们遇到了一例右颈动脉-颈动脉吻合术，其中近段有独特的路线，向前内侧跑，并做了一个发夹转弯。这种类型在相关的英语文献中尚未报道。通常，这种变异走内侧路线，在双侧视神经之间上升。仔细观察MRA图像，包括其源图像，需要正确诊断这种罕见的变异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.