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Orbitofrontal artery arising from a hairpin turn in type 1 persistent primitive olfactory artery: a possible new variant (type 6)

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Abstract

Purpose

To describe a case of a possible new variant of persistent primitive olfactory artery (PPOA).

Case report

A 93-year-old man with left hemiparesis and dysarthria underwent cranial magnetic resonance (MR) imaging and MR angiography using a 3-T scanner. MR imaging showed an acute infarction at the right precentral gyrus. MR angiography showed no steno-occlusive lesions, but the distal A1 segment of the left anterior cerebral artery (ACA) took an extreme anterior course and made a hairpin turn, connecting to the A2 segment, which is indicative of type 1 PPOA. In addition, there was a faintly visualized small artery arising from the hairpin turn. Subsequent computed tomography (CT) angiography showed that the hairpin turn had a mildly dilated arterial lumen, and an extremely tortuous orbitofrontal artery arose from the hairpin turn.

Discussion

There are five types of PPOA. Type 1 is most common, and usually no arterial branch arises from the hairpin turn, except for in type 3 PPOA, which has a branch continuing to the anterior ethmoidal artery arising from the hairpin turn. Using MR and CT angiography, we diagnosed a case of type 1 PPOA associated with the orbitofrontal artery arising from a hairpin turn. A similar previously reported case was diagnosed using catheter angiography.

Conclusion

The present case may be a new variant (type 6) of PPOA. Because the orbitofrontal artery was relatively small in caliber and its proximal segment extremely tortuous, CT angiography had superior utility to MR angiography for demonstrating this variation.

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Fig. 1
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Fig. 3

Modified from reference [9]). ACA anterior cerebral artery, AEA anterior ethmoidal artery, AMCA accessory middle cerebral artery, ICA internal carotid artery, OFA: orbitofrontal artery, PPOA persistent primitive olfactory artery

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Author information

Authors and Affiliations

  1. Department of Radiology, Saitama Sekishinkai Hospital, 2-37-20 Irumagawa Sayama, Saitama, 350-1305, Japan

    Akira Uchino

  2. Department of Neuroendovascular Therapy, Saitama Sekishinkai Hospital, Saitama, Japan

    Masashi Nakadate

Authors
  1. Akira Uchino
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  2. Masashi Nakadate
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Contributions

AU carried out the study design and drafted the manuscript. All authors reviewed the manuscript critically, and have read and approved the final manuscript.

Corresponding author

Correspondence to Akira Uchino.

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Uchino, A., Nakadate, M. Orbitofrontal artery arising from a hairpin turn in type 1 persistent primitive olfactory artery: a possible new variant (type 6). Surg Radiol Anat 44, 527–530 (2022). https://doi.org/10.1007/s00276-022-02914-x

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  • DOI: https://doi.org/10.1007/s00276-022-02914-x

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