Abstract
Purpose
To describe an uncommon anatomical variant of the anterior cerebral artery and the imaging findings.
Methods
A 2-month-old infant with known history of atrial and ventricular septal defects was admitted to our institution for evaluation and management of growth failure. Given the clinical presentation and medical history, magnetic resonance imaging (MRI) of the brain and MR angiography (MRA) were performed to exclude congenital hypopituitarism and any vascular abnormality.
Results
Time of flight MRA revealed trifurcation of the anterior cerebral artery with one of the vessels arising from the ophthalmic segment of the right internal carotid artery; thus, the A1 segment of the left anterior cerebral artery (ACA) was absent, and the right posterior cerebral artery (PCA) had a fetal origin.
Conclusion
Anatomical variants of the cerebral circulation are asymptomatic and found incidentally. Knowledge of these variants and careful examination of CT/MRI angiograms are important for diagnosis and treatment planning.
Similar content being viewed by others
Data availability
Not applicable.
Code availability
Not applicable.
References
Bosma NJ (1977) Infra-optic course of anterior cerebral artery and low bifurcation of the internal carotid artery. Acta Neurochir 38(3–4):305–312. https://doi.org/10.1007/BF01401101
Burbank NS, Morris PP (2005) Unique anomalous origin of the left anterior cerebral artery. AJNR Am J Neuroradiol 26(10):2533–2535
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
Hess CP, Fullerton HJ, Metry DW, Drolet BA, Siegel DH, Auguste KI, Gupta N, Haggstrom AN, Dowd CF, Frieden IJ, Barkovich AJ (2010) Cervical and intracranial arterial anomalies in 70 patients with PHACE syndrome. AJNR Am J Neuroradiol 31(10):1980–1986. https://doi.org/10.3174/ajnr.A2206
Kaplanoglu H, Turan A, Kaplanoglu V, Karacif O (2020) Fetal posterior cerebral artery duplication, true fetal posterior cerebral artery variation and trifurcation anterior cerebral artery association. Surg Radiol Anat 42(10):1267–1270. https://doi.org/10.1007/s00276-020-02523-6
Kim MS, Sim SY (2016) Infraoptic anterior cerebral artery: case series report and literature review. Surg Radiol Anat 38(8):887–891. https://doi.org/10.1007/s00276-016-1651-8
López-Sala P, Alberdi N, Mendigaña M, Bacaicoa MC, Cabada T (2020) Anatomical variants of anterior communicating artery complex. A study by computerized tomographic angiography. J Clin Neurosci 80:182–187. https://doi.org/10.1016/j.jocn.2020.08.019
Peltier J, Fichten A, Havet E, Page C, Foulon P, Laude M, Gars D (2007) The infra-optic course of the anterior cerebral arteries: an anatomic case report. Surg Radiol Anat 29(5):389–392. https://doi.org/10.1007/s00276-007-0221-5
Tahir RA, Haider S, Kole M, Griffith B, Marin H (2019) Anterior cerebral artery: variant anatomy and pathology. J Vasc Interv Neurol 10(3):16–22
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
Not applicable.
Author information
Authors and Affiliations
Contributions
AG: project development, data collection, manuscript writing and final approval. JM: manuscript writing- editing.
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflicts of interest to disclose.
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
Guarnizo, A., Marin Muñoz, J. Anterior cerebral artery trifurcation with infraoptic origin and contralateral A1 segment absence. Surg Radiol Anat 44, 299–301 (2022). https://doi.org/10.1007/s00276-021-02855-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-021-02855-x