Abstract
Introduction
This case report illustrates a new variant in the anterior cerebral artery complex, identified during carotid angioplasty.
Clinical case
A 50-year-old male patient diagnosed with left carotid stenosis was diagnosed and treated by a cerebral angiography. During the procedure, crossed circulation in the anterior cerebral artery was identified. The presence of this variation demanded to discard distal emboli or artery dissection. Angioplasty was performed and the patient followed up without neurological deficit.
Discussion
Among the most possible and prevalent variations in anterior circulation, none of them explain the phenomenon we observed. Therefore, a new variant is established. The knowledge about variants in cerebral circulation is important to rule out pathology.
Conclusion
Cerebral diagnostic angiography has become more available and frequent because of the rising in endovascular tools to treat stroke patients. Considering this new variation and others is important to discard pathology.
Similar content being viewed by others
Data availability
Patient information was obtained with the medical confidential ethics.
References
Alpers BJ, Berry RG, Paddison RM (1959) Anatomical studies of the circle of Willis in normal brain. AMA Arch Neurol Psychiatry 81(4):409–418. https://doi.org/10.1001/archneurpsyc.1959.02340160007002
Baburao-Kardile P, Manohar-Ughade J, Joshi RA (2016) Study of anatomical variations of anterior cerebral artery. Int J Anat Res 4(3):2778–2783
Bożek P, Pilch-Kowalczyk J, Kluczewska E, Zymon-Zagórska A (2012) Detection of cerebral artery fenestrations by computed tomography angiography. Neurol Neurochir Pol 46(3):239–244. https://doi.org/10.5114/ninp.2012.29132
Cui Y, Xu T, Chen J, Tian H et al (2015) Anatomic variations in the anterior circulation of the circle of Willis in cadaveric human brains. Int J Clin Exp Med 8(9):15005–15010
De Gast AN, Van Rooij WJ, Sluzewski M (2008) Fenestrations of the anterior communicating artery: incidence on 3D angiography and relationship to aneurysms. AJNR Am J Neuroradiol 29(2):296–298. https://doi.org/10.3174/ajnr.A0807
Dimmick SJ, Faulder KC (2009) Normal variants of the cerebral circulation at multidetector CT angiography. Radiographics 29(4):1027–1043. https://doi.org/10.1148/rg.294085730
Krzyżewski RM, Tomaszewski KA, Kochana M, Kopeć M et al (2015) Anatomical variations of the anterior communicating artery complex: gender relationship. Surg Radiol Anat 37(1):81–86. https://doi.org/10.1007/s00276-014-1313-7
Menshawi K, Mohr JP, Gutierrez JA (2015) Functional perspective on the embryology and anatomy of the cerebral blood supply. J Stroke 17(2):144–158. https://doi.org/10.5853/jos.2015.17.2.144
Mokin M, Ansari SA, McTaggart RA et al (2019) Indications for thrombectomy in acute ischemic stroke from emergent large vessel occlusion (ELVO): report of the SNIS Standards and Guidelines Committee. J NeuroIntervent Surg 11:215–220. https://doi.org/10.1136/neurintsurg-2018-014640
Okahara M, Kiyosue H, Mori H, Tanoue S et al (2002) Anatomic variations of the cerebral arteries and their embryology: a pictorial review. Eur Radiol 12(10):2548–2561. https://doi.org/10.1007/s00330-001-1286-x
Uchino A, Nomiyama K, Takase Y, Kudo S (2006) Anterior cerebral artery variations detected by MR angiography. Neuroradiology 48(9):647–652. https://doi.org/10.1007/s00234-006-0110-3
Funding
No funding was received to assist with the preparation of this manuscript.
Author information
Authors and Affiliations
Contributions
AAM-LAA: manuscript writing and editing. ARM-PL: data analysis and case description. MM-F: manuscript editing and imaging interpretation. JAM-G: manuscript writing and editing. EEV-S: manuscript writing and editing.
Corresponding author
Ethics declarations
Conflicts of interest
The authors have no financial or proprietary interests in any material discussed in this article.
Consent to participate
The patient signed informed consent regarding the clinical or academic use of his data.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Villarreal-Silva, E.E., López, A.A.M., Morales-Gómez, J.A. et al. Crossed anterior cerebral circulation in the anterior communicating artery complex, first case report with angiographic evidence. Surg Radiol Anat 43, 1955–1959 (2021). https://doi.org/10.1007/s00276-021-02734-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-021-02734-5