Persistent primitive olfactory artery: MR angiographic diagnosis
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Persistent primitive olfactory artery (PPOA) is a relatively rare variation of the proximal anterior cerebral artery (ACA) that generally follows an extreme anteroinferior course and takes a hairpin turn. To our knowledge, incidence of PPOA has not been reported, so we researched cases in our institution records to determine incidence and investigated characteristic features of the condition on MR angiography.
To isolate cases with PPOA, we retrospectively reviewed cranial magnetic resonance (MR) angiographic images of a total of 3,626 patients in our institution and collected similar images from cases with PPOA from our two affiliated hospitals.
We found 14 cases with PPOA (six men and eight women); 5 patients in our institution, representing an incidence of 0.14%, and 9 cases from our group hospitals. The location was on the right in six cases, left in seven, and bilateral in one. An aneurysm was found at the hairpin turn in one patient, and in another patient, the PPOA connected with the accessory middle cerebral artery (MCA) and not the distal ACA.
In our institution, incidence of PPOA on MR angiography was 0.14%. We found no laterality in frequency and rare bilaterality, aneurysm at the point of the hairpin turn, and accessory MCA arising from the PPOA.
KeywordsAnterior cerebral artery Cerebral aneurysm Cerebral arterial variation Magnetic resonance angiography Primitive olfactory artery
We thank Drs. Junji Tanaka, Shinya Kohyama, and Chihiro Suzuki for their contribution to case collection from our two group hospitals. We are also grateful to Rosalyn Uhrig, M.A., for editorial assistance in the preparation of this manuscript.
Conflict of interest
We declare that we have no conflict of interest.