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Cerebral Arterial Variations and Anomalies Diagnosed by MR Angiography

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Abstract

Variations and anomalies in cerebral arteries include persistent primitive vessels that normally regress during early gestation [31] and arteries that normally persist to adult life but regress prematurely. Selective cerebral angiographic studies report numerous such variations and anomalies. Improved MRA image quality using 3-dimensional (3D) time-of-flight (TOF) technique permits incidental detection of even small anomalous arterial branches [66]. Although the variations and anomalies may have limited clinical significance, their correct diagnosis during MRA image interpretation is important to interventional neuroradiologists as well as neurosurgeons, who must be familiar with variations and anomalies in vascular anatomy as they prepare for surgery.

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References

  1. Ashikaga R, Araki Y, Ishida O. Bilateral aberrant internal carotid arteries. Neuroradiology. 1995;37:655–7.

    Article  PubMed  CAS  Google Scholar 

  2. Bhattacharya JJ, Lamin S, Thammaroj J. Otic or mythic? (Letter). AJNR Am J Neuroradiol. 2004;25:160–2.

    PubMed  CAS  Google Scholar 

  3. Burbank NS, Morris PP. Unique anomalous origin of the left anterior cerebral artery. AJNR Am J Neuroradiol. 2005;26:2533–5.

    PubMed  Google Scholar 

  4. Cakirer S, Karaarslan E, Kayabali M, Rozanes I. Separate origins of the left internal and external carotid arteries from the aortic arch: MR angiographic findings. Am J Neuroradiol. 2002;23:1600–2.

    PubMed  Google Scholar 

  5. Caruso G, Vincentelli F, Rabehanta P, Giudicelli G, Grisoli F. Anomalies of the P1 segment of the posterior cerebral rtery: early bifurcation or duplication, fenestration, common trunk with the superior cerebellar artery. Acta Neurochir (Wien). 1991;109:66–71.

    Article  CAS  Google Scholar 

  6. Cinnamon J, Zito J, Chalif DJ, Gorey MT, Black KS, Scuderi DM, et al. Aneurysm of the azygos pericallosal artery: diagnosis by MR imaging and MR angiography. AJNR Am J Neuroradiol. 1992;13:280–2.

    PubMed  CAS  Google Scholar 

  7. Czarnecki EJ, Silbergleit R, Mehta BA, Sanders WP. Absence of the supraclinoid internal carotid artery in association with intracranial aneurysms. Neuroradiology. 1998;40:11–4.

    Article  PubMed  CAS  Google Scholar 

  8. de Gast AN, van Rooij WJ, Sluzewski M. Fenestrations of the anterior communicating artery: incidence on 3D angiography and relationship to aneurysms. AJNR Am J Neuroradiol. 2008;29:296–8.

    Article  PubMed  Google Scholar 

  9. Fujita N, Shimada N, Takimoto H, Satou T. MR appearance of the persistent hypoglossal artery. AJNR Am J Neuroradiol. 1995;16:990–2.

    PubMed  CAS  Google Scholar 

  10. Gailloud P, Albayram S, Fasel JH, Beauchamp NJ, Murphy KJ. Angiographic and embryologic considerations in five cases of middle cerebral artery fenestration. AJNR Am J Neuroradiol. 2002;23:585–7.

    PubMed  Google Scholar 

  11. Gailloud P, Carpenter J, Heck DV, Murphy KJ. Pseudofenestration of the cervical internal carotid artery: a pathologic process that simulates an anatomic variant. AJNR Am J Neuroradiol. 2004;25:421–4.

    PubMed  Google Scholar 

  12. Gumus T, Onal B, Ilgit ET. Bilateral persistence of type 1 proatlantal arteries: report of a case and review of the literature. AJNR Am J Neuroradiol. 2004;25:1622–4.

    PubMed  Google Scholar 

  13. Haehnel S, Hartmann M, Jansen O, Sartor K. Persistent hypoglossal artery: MRI, MRA and digital subtraction angiography. Neuroradiology. 2001;43:767–9.

    Article  Google Scholar 

  14. Huber P, Braun J, Hirschmann D, Agyeman JF. Incidence of berry aneurysms of the unpaired pericallosal artery: angiographic study. Neuroradiology. 1980;19:143–7.

    Article  PubMed  CAS  Google Scholar 

  15. Hyogo T, Nakagawara J, Nakamura J, Suematsu K. Multiple segmental agenesis of the cerebral arteries: case report. Neuroradiology. 1996;38:433–6.

    Article  PubMed  CAS  Google Scholar 

  16. Ito J, Maeda H, Inoue K, Onishi Y. Fenestration of the middle cerebral artery. Neuroradiology. 1977;13:37–9.

    Article  PubMed  CAS  Google Scholar 

  17. Ito J, Takeda N, Suzuki Y, Takeuchi S, Osugi S, Yoshida Y. Anomalous origin of the anterior inferior cerebellar arteries from the internal carotid artery. Neuroradiology. 1980;19:105–9.

    Article  PubMed  CAS  Google Scholar 

  18. Ito J, Washiyama K, Kim CH, Ibuchi Y. Fenestration of the anterior cerebral artery. Neuroradiology. 1981;21:277–80.

    Article  PubMed  CAS  Google Scholar 

  19. Kodama T. Aberrant internal carotid artery, partial absence of internal carotid artery. In: Sakai O, editor. A key to head and neck imaging. Tokyo: Shujunsha; 2002. p. 22 (in Japanese).

    Google Scholar 

  20. Komiyama M, Nakajima H, Nishikawa M, Yasui T. Middle cerebral artery variations: duplicated and accessory arteries. AJNR Am J Neuroradiol. 1998;19:45–9.

    PubMed  CAS  Google Scholar 

  21. Komiyama M, Nishikawa M, Yasui T. The accessory middle cerebral artery as a collateral blood supply. AJNR Am J Neuroradiol. 1997;18:587–90.

    PubMed  CAS  Google Scholar 

  22. Kowada M, Yamaguchi K, Takahashi H. Fenestration of the vertebral artery with a review of 23 cases in Japan. Radiology. 1972;103:343–6.

    PubMed  CAS  Google Scholar 

  23. Krabbe-Hartkamp MJ, van der Grond J, de Leeuw F-E, de Groot J-C, Algra A, Hillen B, et al. Circle of Willis: morphologic variation on three-dimensional time-of-flight MR angiograms. Radiology. 1998;207:103–11.

    PubMed  CAS  Google Scholar 

  24. Layton KF, Kallmes DF, Cloft HJ, Lindell EP, Cox VS. Bovine aortic arch variant in humans: clarification of a common misnomer. AJNR Am J Neuroradiol. 2006;27:1541–2.

    PubMed  CAS  Google Scholar 

  25. Luh GY, Dean BL, Tomsick TA, Wallace RC. The persistent fetal carotid-vertebrobasilar anastomoses. AJR Am J Roentgenol. 1999;172:1427–32.

    PubMed  CAS  Google Scholar 

  26. Mangla S, Teitelbaum GP. Multichannnel fenestrations of the petrous segment of the internal carotid artery. AJNR Am J Neuroradiol. 1999;20:590–2.

    PubMed  CAS  Google Scholar 

  27. Meaney JF, Sallomi DF, Miles JB. Transhypophyseal primitive trigeminal artery: demonstration with MRA. J Comput Assist Tomogr. 1994;18:991–4.

    Article  PubMed  CAS  Google Scholar 

  28. Morimoto T, NittaK KK, Hashizume K. The anomaly of a non-bifurcating cervical carotid artery. J Neurosurg. 1990;72:130–2.

    Article  PubMed  CAS  Google Scholar 

  29. Ogawa T, Miyauchi T, Kato T, Tamakawa Y. Internal carotid origin of double ophthalmic arteries. Neuroradiology. 1990;32:508–10.

    Article  PubMed  CAS  Google Scholar 

  30. Okahara M, Kiyosue H, Mori H, Tanoue S, Sainou M, Nagatomi H. Anatomic variations of the cerebral arteries and their embryology: a pictorial review. Eur Radiol. 2002;12:2548–61.

    PubMed  Google Scholar 

  31. Padget DH. The development of the cranial arteries in the human embryo. Contrib Embryol. 1948;32:205–61.

    Google Scholar 

  32. Patel AB, Gandhi CD, Bederson JB. Angiographic documentation of a persistent otic artery. AJNR Am J Neuroradiol. 2003;24:124–6.

    PubMed  Google Scholar 

  33. Purkayastha S, Gupta AK, Varma R, Kapilamoorthy TR. Proatlantal intersegmental arteries of external carotid origin associated with Galen’s vein malformation. AJNR Am J Neuroradiol. 2005;26:2378–83.

    PubMed  Google Scholar 

  34. Quint DJ, Boulos RS, Spera TD. Congenital absence of the cervical and petrous internal carotid artery with intercavernous anastomosis. AJNR Am J Neuroradiol. 1989;10:435–9.

    PubMed  CAS  Google Scholar 

  35. Quint DJ, Silbergleit R, Young WC. Absence of the carotid canals at skull base CT. Radiology. 1992;182:477–81.

    PubMed  CAS  Google Scholar 

  36. Reynolds AF, Jr, Stovring J, Turner PT. Persistent otic artery. Surg Neurol. 1980;13:115–7.

    PubMed  Google Scholar 

  37. Richardson DN, Elster AD, Ball MR. Intrasellar trigeminal artery. AJNR Am J Neuroradiol. 1989;10:205.

    PubMed  CAS  Google Scholar 

  38. Sanders WP, Sorek PA, Mehta BA. Fenestration of intracranial arteries with special attention to associated aneurysms and other anomalies. AJNR Am J Neuroradiol. 1993;14:675–80.

    PubMed  CAS  Google Scholar 

  39. Shaw JA, Gravereaux EC, Eisenhauer AC. Carotid stenting in the bovine arch. Catheter Cardiovasc Interv. 2003;60:566–9.

    Article  PubMed  Google Scholar 

  40. Siqueira M, Piske R, Ono M, Marino Junior R. Cerebellar arteries originating from the internal carotid artery. AJNR Am J Neuroradiol. 1993;14:1229–35.

    PubMed  CAS  Google Scholar 

  41. Suzuki S, Kuwabara Y, Hatano R, Iwai T. Duplicate origin of left vertebral artery. Neuroradiology. 1978;15:27–9.

    Article  PubMed  Google Scholar 

  42. Suzuki S, NobechiT II, Yakura M, Iwashita K. Persistent proatlantal intersegmental artery and occipital artery originating from internal carotid artery. Neuroradiology. 1979;17:105–9.

    Article  PubMed  CAS  Google Scholar 

  43. Takahashi M, Tamakawa Y, Kishikawa T, Kowada M. Fenestration of the basilar artery. Report of three cases and review of the literature. Radiology. 1973;109:79–82.

    PubMed  CAS  Google Scholar 

  44. Takahashi S, Hoshino F, Uemura K, Takahashi A, Sakamoto K. Accessory middle cerebral artery: is it a variant form of the recurrent artery of Heubner? AJNR Am J Neuroradiol. 1989;10:563–8.

    PubMed  CAS  Google Scholar 

  45. Takahashi S, Suga T, Kawata Y, Sakamoto K. Anterior choroidal artery: angiographic analysis of variations and anomalies. AJNR Am J Neuroradiol. 1990;11:719–29.

    PubMed  CAS  Google Scholar 

  46. Takahashi T, Suzuki S, Ohkuma H, Iwabuchi T. Aneurysm at a duplication of the middle cerebral artery. AJNR Am J Neuroradiol. 1994;15:1166–8.

    PubMed  CAS  Google Scholar 

  47. Tasker AD, Byrne JV. Basilar artery fenestration in association with aneurysms of the posterior cerebral circulation. Neuroradiology. 1997;39:185–9.

    Article  PubMed  CAS  Google Scholar 

  48. Teal JS, Rumbaugh CL, Bergeron RT, Scanlan RL, Segall HD. Persistent carotid-superior cerebellar artery anastomosis: a variant of persistent trigeminal artery. Radiology. 1972;103:335–41.

    PubMed  CAS  Google Scholar 

  49. Teal JS, Rumbaugh CL, Segall HD, Bergeron RT. Anomalous branches of the internal carotid artery. Radiology. 1973;106:567–73.

    PubMed  CAS  Google Scholar 

  50. Teal JS, Rumbaugh CL, Bergeron RT, Segall HD. Anomalies of the middle cerebral artery: accessory artery, duplication, and early bifurcation. Am J Roentogenol Radium Ther Nucl Med. 1973;118:567–75.

    CAS  Google Scholar 

  51. Tsuji T, Abe M, Tabuchi K. Aneurysm of a persistent primitive olfactory artery. Case report. J Neurosurg. 1995;83:138–40.

    Article  PubMed  CAS  Google Scholar 

  52. Uchino A. Normal anatomy and variations of the cerebral and neck arteries. In: Tsuchiya K, editor. Vascular imaging: cerebral and neck vessels. Yodosha: Tokyo; 2008. p. 31–47 (In Japanese).

    Google Scholar 

  53. Uchino A, Abe M, Sawada A, Takase Y, Kudo S. Extremely tortuous superior cerebellar artery. Eur Radiol. 2003;13 Suppl 4:L237–8.

    Article  Google Scholar 

  54. Uchino A, Kato A, Abe M, Kudo S. Association of cerebral arteriovenous malformation with cerebral arterial fenestration. Eur Radiol. 2001;11:493–6.

    Article  PubMed  CAS  Google Scholar 

  55. Uchino A, Kato A, Takase Y, Kudo S. Middle cerebral artery variations detected by magnetic resonance angiography. Eur Radiol. 2000;10:560–3.

    Article  PubMed  CAS  Google Scholar 

  56. Uchino A, Kato A, Takase Y, Kudo S. Persistent trigeminal artery variants detected by MR angiography. Eur Radiol. 2000;10:1801–4.

    Article  PubMed  CAS  Google Scholar 

  57. Uchino A, Kato A, Takase Y, Kudo S. Basilar artery fenestrations detected by MR angiography. Radiat Med. 2001;19:71–4.

    PubMed  CAS  Google Scholar 

  58. Uchino A, Matsunaga M, Ohno M. Arteriovenous malformation of the corpus callosum associated with persistent primitive trigeminal artery. Case report Neurol Med Chir (Tokyo). 1989;29:429–32.

    Article  CAS  Google Scholar 

  59. Uchino A, Mizushima A, Aibe H, Tanaka M. MR imaging and MR angiography of persistent trigeminal artery and its variant. Clin Imaging. 1996;20:247–52.

    Article  PubMed  CAS  Google Scholar 

  60. Uchino A, Nomiyama K, Takase Y, Kohata T, Kudo S. Intracavernous fenestration of the internal carotid artery. Eur Radiol. 2006;16:1623–4.

    Article  PubMed  Google Scholar 

  61. Uchino A, Nomiyama K, Takase Y, Kudo S. Anterior cerebral artery variations detected by MR angiography. Neuroradiology. 2006;48:647–52.

    Article  PubMed  Google Scholar 

  62. Uchino A, Sawada A, Hirakawa N, Totoki T, Kudo S. Congenital absence of the internal carotid artery diagnosed during investigation of trigeminal neuralgia. Eur Radiol. 2002;12:2339–42.

    Article  PubMed  CAS  Google Scholar 

  63. Uchino A, Sawada A, Takase Y, Fujita I, Kudo S. Extreme fenestration of the basilar artery associated with cleft palate, nasopharyngeal mature teratoma, and hypophyseal duplication. Eur Radiol. 2002;12:2087–90.

    Article  PubMed  CAS  Google Scholar 

  64. Uchino A, Sawada A, Takase Y, Imaizumi T, Egashira R, Matsuo M, et al. Carotid-anterior cerebral artery anastomosis: MR angiographic features and literature review. Clin Imaging. 2004;28:377–80.

    Article  PubMed  Google Scholar 

  65. Uchino A, Sawada A, Takase Y, Kudo S. Extreme fenestration of the right vertebral artery: magnetic resonance angiographic demonstration. Eur Radiol. 2002;12 Suppl 3:S32–4.

    PubMed  Google Scholar 

  66. Uchino A, Sawada A, Takase Y, Kudo S. MR angiography of anomalous branches of the internal carotid artery. AJR Am J Roentogenol. 2003;181:1409–14.

    Google Scholar 

  67. Uchino A, Sawada A, Takase Y, Kudo S. Persistent primitive olfactory artery: diagnosis with MR angiography. Clin Imaging. 2001;25:258–61.

    Article  PubMed  CAS  Google Scholar 

  68. Uchino A, Sawada A, Takase Y, Kudo S, Koizumi T. Moyamoya disease associated with an anterior inferior cerebellar artery arising from a persistent trigeminal artery. Eur Radiol. 2002;12 Suppl 3:S14–7.

    PubMed  Google Scholar 

  69. Uchino A, Sawada A, Takase Y, Kudo S. Variations of the superior cerebellar artery: MR angiographic demonstration. Radiat Med. 2003;21:235–8.

    PubMed  Google Scholar 

  70. Uchino A, Takase Y, Nomiyama K, Egashira R, Kudo S. Fenestrations of the middle cerebral artery detected by MR angiography. Magn Reson Med Sci. 2006;5:51–5.

    Article  PubMed  Google Scholar 

  71. Yamaguchi K, Uchino A, Sawada A, Takase Y, Kuroda Y, Kudo S. Bilateral anterior cerebral artery territory infarction associated with unilateral hypoplasia of the A1 segment: report of two cases. Radiat Med. 2004;22:422–5.

    PubMed  Google Scholar 

  72. Yamazaki M, Okawa A, Hashimoto M, Aiba A, Someya Y, Koda M. Abnormal course of the vertebral artery at the craniovertebral junction in patients with Down syndrome visualized by three-dimensional CT angiography. Neuroradiology. 2008;50:485–90.

    Article  PubMed  Google Scholar 

  73. Yilmaz T, Bilgen C, Savas R, Alper H. Persistent stapedial artery: MR angiographic and CT findings. AJNR Am J Neuroradiol. 2003;24:1133–5.

    PubMed  Google Scholar 

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Uchino, A. (2011). Cerebral Arterial Variations and Anomalies Diagnosed by MR Angiography. In: Takahashi, S. (eds) Neurovascular Imaging. Springer, London. https://doi.org/10.1007/978-1-84882-134-7_5

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