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Fenestrations of the intracranial vertebrobasilar system diagnosed by MR angiography

  • Diagnostic Neuroradiology
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Abstract

Introduction

Fenestrations of cerebral arteries are most common in the vertebrobasilar (VB) system, and magnetic resonance (MR) angiographic studies of these variations are sparse.

Methods

We retrospectively reviewed MR angiographic images of 3,327 patients; images were obtained using two 1.5-T imagers and picked up fenestrations of the intracranial vertebral artery (VA), VB junction, and basilar artery (BA) for evaluation.

Results

In 92 patients, we found 93 fenestrations (2.80%), which included 18 of the intracranial VA (0.54% prevalence), 6 of the VB junction (0.18%), and 69 of the BA (2.07%). Most VA fenestrations were large, and the posterior inferior cerebellar artery arose from the fenestrated segment in 10 patients (56%). Fenestrations of the VB junction were small and triangular. Sixty-five (94%) of the 69 BA fenestrations were located at the proximal segment and had small slit-like configurations. The anterior inferior cerebellar artery arose from the fenestrated segment in 27 patients (37%). We found 18 cerebral aneurysms in 16 (17%) of the 92 patients with fenestration but detected only one aneurysm at the fenestration.

Conclusion

The overall prevalence of fenestrations of the intracranial VB system was 2.77%. We found associated cerebral aneurysms relatively frequently but rarely at the fenestration.

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References

  1. Uchino A, Kato A, Takase Y et al (2001) Basilar artery fenestrations detected by MR angiography. Radiat Med 19:71–74

    PubMed  CAS  Google Scholar 

  2. Tanaka M, Kikuchi Y, Ouchi T (2006) Neuroradiological analysis of 23 cases of basilar artery fenestration based on 2280 cases of MR angiographies. Interv Neuroradiol 12(Suppl 1):39–44

    PubMed  CAS  Google Scholar 

  3. Uchino A, Saito N, Watadani T, et al. (2011) Vertebral artery variations at the C1-2 level diagnosed by magnetic resonance angiography. Neuroradiology. doi:10.1007/s00234-011-0849-z

  4. van Rooij SB, van Rooij WJ, Sluzewski M et al (2009) Fenestrations of intracranial arteries detected with 3D rotational angiography. AJNR Am J Neuroradiol 30:1347–1350

    Article  PubMed  Google Scholar 

  5. Kowada M, Yamaguchi K, Takahashi H (1972) Fenestration of the vertebral artery with a review of 23 cases in Japan. Radiology 103:343–346

    PubMed  CAS  Google Scholar 

  6. Lasjaunias P, Braun JP, Hasso AN (1980) True and false fenestration of the vertebral artery. J Neuroradiol 7:157–166 [Article in English, French]

    PubMed  CAS  Google Scholar 

  7. Uchino A, Sawada A, Takase Y et al (2002) Extreme fenestration of the right vertebral artery: magnetic resonance angiographic demonstration. Eur Radiol 12:S32–S34

    Article  PubMed  Google Scholar 

  8. Lesley WS, Rajab MH, Case RS (2007) Double origin of the posterior inferior cerebellar artery: association with intracranial aneurysm on catheter angiography. AJR Am J Roentgenol 189:893–897

    Article  PubMed  Google Scholar 

  9. Plumb AA, Herwadkar A, Laitt R (2009) Double origin of the posterior inferior cerebellar artery with findings on conventional and CT angiography. Surg Radiol Anat 31:393–395

    Article  PubMed  Google Scholar 

  10. Takahashi M, Tamakawa Y, Kishikawa T et al (1973) Fenestration of the basilar artery. Report of three cases and review of the literature. Radiology 109:79–82

    PubMed  CAS  Google Scholar 

  11. Wollschlaeger G, Wollschlaeger PB, Lucas FV et al (1967) Experience and result with postmortem cerebral angiography performed as routine procedure of the autopsy. Am J Roentgenol Radium Ther Nucl Med 101:68–87

    PubMed  CAS  Google Scholar 

  12. Padget DH (1948) The development of cranial arteries in the human embryo. Contrib Embryol 32:207–261

    Google Scholar 

  13. Goldstein JH, Woodcock R, Do HM et al (1999) Complete duplication or extreme fenestration of the basilar artery. AJNR Am J Neuroradiol 20:149–150

    PubMed  CAS  Google Scholar 

  14. Uchino A, Sawada A, Takase Y et al (2002) Extreme fenestration of the basilar artery associated with cleft palate, nasopharyngeal mature teratoma, and hypophyseal duplication. Eur Radiol 12:2087–2090

    Article  PubMed  CAS  Google Scholar 

  15. Campos J, Fox AJ, Viñuela F et al (1987) Saccular aneurysms in basilar artery fenestration. AJNR Am J Neuroradiol 8:233–236

    PubMed  CAS  Google Scholar 

  16. Tasker AD, Byrne JV (1997) Basilar artery fenestration in association with aneurysms of the posterior cerebral circulation. Neuroradiology 39:185–189

    Article  PubMed  CAS  Google Scholar 

  17. Sanders WP, Sorek PA, Mehta BA (1993) Fenestration of intracranial arteries with special attention to associated aneurysms and other anomalies. AJNR Am J Neuroradiol 14:675–680

    PubMed  CAS  Google Scholar 

  18. Uchino A, Kato A, Abe M et al (2001) Association of cerebral arteriovenous malformation with cerebral arterial fenestration. Eur Radiol 11:493–496

    Article  PubMed  CAS  Google Scholar 

  19. Scherer A, Siebler M, Aulich A (2002) Virtual arterial endoscopy as a diagnostic aid in a patient with basilar artery fenestration and thromboembolic pontine infarct. AJNR Am J Neuroradiol 23:1237–1239

    PubMed  Google Scholar 

  20. Kloska SP, Schlegel PM, Sträter R et al (2006) Causality of pediatric brainstem infarction and basilar artery fenestration? Pediatr Neurol 35:436–438

    Article  PubMed  Google Scholar 

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Acknowledgment

We thank Rosalyn Uhrig, M.A., for editorial assistance in the preparation of this manuscript.

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We declare that we have no conflict of interest.

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Correspondence to Akira Uchino.

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Uchino, A., Saito, N., Okada, Y. et al. Fenestrations of the intracranial vertebrobasilar system diagnosed by MR angiography. Neuroradiology 54, 445–450 (2012). https://doi.org/10.1007/s00234-011-0903-x

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  • DOI: https://doi.org/10.1007/s00234-011-0903-x

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