Summary
This study attempts to analyse the intra-operative anatomical findings of the lenticulostriate artery (LSA) in 60 patients with middle cerebral artery (MCA) aneurysms who were operated on at the Neurosurgical Department of Atatürk University Medical School, Erzurum, Türkiye.
All patients underwent radical surgery for aneurysm by the right or left pterional approach. The findings were recorded during surgical intervention using slides and videotapes of the operations. On average there were 4 (range, 1–14, total number=240) LSAs, in one hemisphere, per case with MCA aneurysm. Twenty percent of LSAs (n=48) arise from the prebifurcation part of the M1 segment, 65% (n=156) arise from the postbifurcation part of the M1 segment, and 15% (n=36) arise from the proximal part of the M2 segment. The great majority of the LSAs (85%, n=204) orginated along the proximal part of the MCA. Of a total of 240 LSAs, 125 (52%) originated from one single large vessel, a stem artery which then divided after 2–10 mm into many branches, 85 (35%) originated as two large proximal trunks, and 30 (13%) originated as multiple small arteries arising along the whole infero-medial wall of the M1 segment of MCA.
We concluded that recognition of the anatomical variations of the LSA and detailed knowledge of the microvascular relationships of the MCA aneurysms, will allow neurosurgeons to construct a better and safer microdissection plan, to save time, and to prevent postoperative neurological deficits.
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References
Aydin IH, Önder A, Takçi E, Kadioglu HH, Kayaoglu ÇR, Tüzün Y (1994) Heubner's artery variations in anterior communicating artery aneurysms. Acta Neurochir (Wien) 127: 17–20
Dujovny M, Kossovsky N, Barrionuevo PJ,et al (1982) Ependymitis and arachnoiditis induced by intraventricular contrast media. Surg Neurol 18: 216–224
Flamm ES, Fein JM (1985) Middle cerebral artery aneurysm. In: Fein JM, Flamm ES (eds) Cerebrovascular surgery, vol 3. Springer, Berlin Heidelberg New York Tokyo, pp 861–877
Gibo H, Carver CC, Rhoton AL Jr, Lenkey C, Mitchell RJ (1981) Microsurgical anatomy of the middle cerebral artery. J Neurosurg 54: 151–169
Grand W (1980) Microsurgical anatomy of the proximal middle cerebral artery and the internal carotid artery bifurcation. Neurosurgery 7: 215–218
Gomes F, Dujovny M, Umasky F,et al (1984) Microsurgical anatomy of the recurrent artery of Heubner. J Neurosurg 60: 130–139
Hosoda K, Fujita S, Kawaguchi T, Shose Y, Hamano S (1995) Saccular aneurysms of the proximal (M1) segment of the middle cerebral artery. Neurosurgery 36: 441–446
Ito Z (1985) General incidence of cerebral aneurysms. In: Yasui N, Kamiyama H(eds) Microsurgery of cerebral aneurysms. Elsevier, Niigata, pp 11–13
Kaplan HA (1965) The lateral perofrating branches of the anterior and middle cerebral arteries. J Neurosurg 23: 305–310
Kaplan HA, Krieger AJ (1980) Vascular anatomy of the preoptic region of the brain. Acta Neurochir (Wien) 54: 233–241
Kassel NF, Torner JC (1984) The international cooperative study on timing of aneurysm surgery. An update. Stroke 45: 148–154
Lipovsek M (1973) Ruptured aneurysms of the proximal middle cerebral artery. J Neurosurg 39: 498–502
Ojemann RG, Heros RC, Crowell RM (1988) Middle cerebral artery aneurysms. In: Ojemann RG, Heros RC, Crowell RM (ed) Surgical management of cerebrovascular disease. Williams and Wilkins, Baltimore, pp 241–252
Rhoton AL Jr (1994) Anatomic foundations of aneurysms surgery. Honoured Guest Lecture. Clin Neurosurg 41: 289–333
Rhoton AL Jr (1980) Anatomy of saccular aneurysms. Surg Neurol 14: 59–66
Robinson RG (1971) Ruptured aneurysms of the middle cerebral artery. J Neurosurg 35: 25–33
Rosner SS, Rhoton AL Jr, Ono M, Barry M (1984) Microsurgical anatomy of the anterior perforating arteries. J Neurosurg 61: 468–485
Umansky F, Gomes FB, Dujovny M, Diaz FG, Ausman JI, Mirchandani H, Berman SK (1985) The perforating branches of the middle cerebral artery. A microanatomical study. J Neurosurg 62: 261–268
Yaşargil MG (1984) Middle cerebral artery. In: Yaşargil MG (ed) Microneurosurgery, vol 1. Thieme, Stuttgart, pp 72–91
Yaşargil MG (1984) Aneurysm clipping. In: Yaşargil MG (ed) Microneurosurgery, vol 1. Thieme, Stuttgart, pp 245–264
Yaşargil MG (1984) Middle cerebral artery aneurysm. In: Yaşargil MG (ed) Microneurosurgery, vol 2. Thieme, Stuttgart, pp 124–164
Yaşargil MG (1984) Multiple aneurysms. In: Yaşargil MG (ed) Microneurosurgery, vol 2. Thieme, Stuttgart, pp 305–328
Yaşargil MG, Fox JL, Ray MW (1975) The operative approach to aneurysms of the anterior communicating artery. In: Krayenbühl HA (ed) Advances and technical standards in neurosurgery, vol 2. Springer, Wien New York, pp 113–170
Yaşargil MG, Smith RD (1982) Management of aneurysms of anterior circulation by intracranial procedures. In: Youmans JR (ed) Neurological surgery, 2nd Ed, Vol III. Saunders, Philadelphia, pp 1663–1696
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Aydin, I.H., Takçi, E., Kadioglu, H.H. et al. The variations of lenticulostriate arteries in the middle cerebral artery aneurysms. Acta neurochir 138, 555–559 (1996). https://doi.org/10.1007/BF01411176
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DOI: https://doi.org/10.1007/BF01411176