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Prevalence of fenestrated basilar artery with magnetic resonance angiography: a transversal study

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Abstract

Fenestration of the basilar artery (BA) is a rare anatomical variation in comparison to those of the other intracranial arteries constituting the cerebral arterial circle. The incidence is difficult to ascertain and data vary according to type of series and modalities of detection. Basilar artery fenestration (BAF) has been reported in association with arteriovenous malformations, vascular variants, other developmental anomalies and neurovascular conflicts as a consequence of relations between the arterial branches of the BA and the nerves and other structures in the posterior cranial fossa. However, the real clinical interest of BAF is due to the possible formation of an aneurysm at the junction of the fenestrated segment and less frequently to the thrombosis of the vessels. With the aim to establish the prevalence of BAF in our population, we made a transversal pilot study of the first 200 MR angiographies performed on patients attending for the first time to control their base pathology (vascular or not). We have described three patients with this condition (representing a prevalence of 1.5 % on MR angiography) to shed additional light on this anomaly, two cases located at 1/3 proximal end (type 1-BAF) and one case located at joint 1/3 medium–1/3 distal end, locating distal to the anterior inferior cerebellar artery (type 4-BAF). In neither case was any other lesion found (i.e. aneurysm, infarctions, ischemia or thromboembolism). The pertinent clinical anatomy and embryological basis for this variation are reviewed, and the possible clinical implications and associated findings are discussed.

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References

  1. Ahn JH, Kim MS, Lee SJ, Park K, Lee CH (2006) Fenestration and duplication of the vertebrobasilar artery detected by conventional angiography and magnetic resonance angiography. J Korean Neurosurg Soc 39:355–359

    Google Scholar 

  2. Barcia Goyanes JJ (1978) Onomatología Anatómica Nova, vol 1. Universidad de Valencia, Valencia, pp 206–207 (in Spanish)

  3. Bayrak AH, Senturk S, Akay HO, Ozmen CA, Bukte Y, Nazaroglu H (2011) The frequency of intracranial arterial fenestrations: a study with 64-detector CT-angiography. Eur J Radiol 77:392–396

    Article  PubMed  Google Scholar 

  4. Berry AD 3rd, Kepes JJ, Wetzel MD (1988) Segmental duplication of the basilar artery with thrombosis. Stroke 19:256–260

    Article  PubMed  Google Scholar 

  5. Bharatha A, Aviv RI, White J, Fox AJ, Symons SP (2008) Intracranial arterial fenestrations: frequency on CT angiography and association with other vascular lesions. Surg Radiol Anat 30:397–401

    Article  PubMed  Google Scholar 

  6. Busch W (1966) Contribution to the morphology and pathology of the basilar artery. Results of the study of 1000 brains. Arch Psychiatr Nervenkr 208:326–344

    Article  PubMed  CAS  Google Scholar 

  7. deAndrade GC, de Oliveira JG, Dauar RF, Nalli DR, Braga FM (2005) Dissecting aneurysm of the intracranial fenestrated vertebral artery submitted to endovascular treatment: case report. Arq Neuropsiquiatr 63:352–356

    Article  Google Scholar 

  8. deCaro R, Serafini MT, Galli S, Parenti A, Guidolin D, Munari PF (1995) Anatomy of segmental duplication in the human basilar artery. Possible site of aneurysm formation. Clin Neuropathol 14:303–309

    CAS  Google Scholar 

  9. Dimmick SJ, Faulder KC (2009) Normal variants of the cerebral circulation at multidetector CT angiography. Radiographics 29:1027–1043

    Article  PubMed  Google Scholar 

  10. Dodevski A, Lazareska M, Tosovska-Lazarova D, Zhivadinovik J, Stojkoski A (2011) Basilar artery fenestration. Folia Morphol 70:80–83

    CAS  Google Scholar 

  11. Ernst E (2002) Manipulation of the cervical spine: a systematic review of case reports of serious adverse events, 1995–2001. Med J Aust 176:376–380

    PubMed  Google Scholar 

  12. Hoh BL, Rabinov JD, Pryor JC, Hirsch JA, Dooling EC, Ogilvy CS (2004) Persistent nonfused segments of the basilar artery: longitudinal versus axial nonfusion. AJNR Am J Neuroradiol 25:1194–1196

    PubMed  Google Scholar 

  13. Islak C, Kocer N, Kantarci F, Saatci I, Uzma O, Canbaz B (2002) Endovascular management of basilar artery aneurysms associated with fenestrations. AJNR Am J Neuroradiol 23:958–964

    PubMed  Google Scholar 

  14. Krings T, Baccin CE, Alvarez H, Ozanne A, Stracke P, Lasjaunias PL (2007) Segmental unfused basilar artery with kissing aneurysms: report of three cases and literature review. Acta Neurochir (Wien) 149:567–574

    Article  CAS  Google Scholar 

  15. Lasjaunias P, Manelfe C, Roche A, Rascol A (1979) Segmental aplasia of the basilar artery in man. Report of a case. J Neuroradiol 6:127–136

    PubMed  CAS  Google Scholar 

  16. Lazorthes G, Gouazé, Salamon G (1976) Vascularisation et circulation de l’encéphale, vol 1. Masson, Paris, pp 8–10 (in French)

  17. Matricali B, van Dulken H (1981) Aneurysm of fenestrated basilar artery. Surg Neurol 15(3):189–191

    Article  PubMed  CAS  Google Scholar 

  18. Padget DH (1948) The development of the cranial arteries in the human embryo. Contrib Embryol Carnegie Inst Wash 32:205–261

    Google Scholar 

  19. Peluso JP, van Rooij WJ, Sluzewski M, Beute GN (2007) Aneurysms of the vertebrobasilar junction: incidence, clinical presentation, and outcome of endovascular treatment. AJNR Am J Neuroradiol 28:1747–1751

    Article  PubMed  CAS  Google Scholar 

  20. 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 

  21. Stopford JSB (1916) The arteries of the pons and medulla oblongata. J Anat Physiol 50:132–164

    Google Scholar 

  22. Surchev N (2008) Arterial relationships to the nerves and some rigid structures in the posterior cranial fossa. Clin Anat 21:492–500

    Article  PubMed  CAS  Google Scholar 

  23. 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 20:39–44

    Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  25. Teal JS, Rumbaugh CL, Bergeron RT, Segall HD (1973) Angiographic demonstration of fenestrations of the intradural intracranial arteries. Radiology 106:123–126

    PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  27. Uchino A, Saito N, Okada Y, Kozawa E, Nishi N, Mizukoshi W, Inoue K, Nakajima R, Takahashi M (2012) Fenestrations of the intracranial vertebrobasilar system diagnosed by MR angiography. Neuroradiology 54(5):445–450

    Article  PubMed  Google Scholar 

  28. van Rooij SBT, van Rooij WJ, Sluzewski M, Sprengers MES (2009) Fenestrations of intracranial arteries detected with 3D rotational angiography. AJNR Am J Neuroradiol 30:1347–1350

    Article  PubMed  Google Scholar 

  29. Zurada A, St Gielecki J, Baron J, Zawiliński J, Kozłowska H (2008) Interactive 3D stereoscopic digital-image analysis of the basilar artery bifurcation. Clin Anat 21:127–137

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank Mrs Ana-Mª Alvarez-Castrosín for her assistance with manuscript preparation.

Conflict of interest

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Ethical Standard

This study was approved by the Ethical Committee of the Hospital Clínico “San Carlos” of Madrid (12/318-E).

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Authors and Affiliations

  1. Department of Anatomy and Embryology 2, Faculty of Medicine, University Complutense, 28040, Madrid, Spain

    L. A. Arráez-Aybar

  2. Institute of Embryology of Complutense University of Madrid, Madrid, Spain

    L. A. Arráez-Aybar & A. Villar-Martin

  3. Department of Radiology, Dr Peset University Hospital, Valencia, Spain

    C. Poyatos-Ruiperez

  4. Department of Neurosurgery, Hospital Clínico “San Carlos”, CUM, Madrid, Spain

    G. Rodriguez-Boto

  5. Department of Radiology, Hospital Clínico “San Carlos”, CUM, Madrid, Spain

    J. Arrazola-Garcia

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  1. L. A. Arráez-Aybar
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  2. A. Villar-Martin
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  3. C. Poyatos-Ruiperez
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  4. G. Rodriguez-Boto
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  5. J. Arrazola-Garcia
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Correspondence to L. A. Arráez-Aybar.

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Arráez-Aybar, L.A., Villar-Martin, A., Poyatos-Ruiperez, C. et al. Prevalence of fenestrated basilar artery with magnetic resonance angiography: a transversal study. Surg Radiol Anat 35, 487–493 (2013). https://doi.org/10.1007/s00276-012-1053-5

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  • DOI: https://doi.org/10.1007/s00276-012-1053-5

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