Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

Three-Dimensional Angiographic Demonstration of Plexiform Fenestrations of the Proximal Anterior Cerebral Artery Associated with a Ruptured Aneurysm

  • Koh, Jun-Seok (Department of Neurosurgery, Sroke and Neurological Disorders Center, East-West Neo Medical Hospital, Kyung Hee University School of Medicine) ;
  • Lee, Seung-Hwan (Department of Neurosurgery, Sroke and Neurological Disorders Center, East-West Neo Medical Hospital, Kyung Hee University School of Medicine) ;
  • Bang, Jae-Seung (Department of Neurosurgery, Sroke and Neurological Disorders Center, East-West Neo Medical Hospital, Kyung Hee University School of Medicine) ;
  • Kim, Gook-Ki (Department of Neurosurgery, Sroke and Neurological Disorders Center, East-West Neo Medical Hospital, Kyung Hee University School of Medicine)
  • Published : 2008.11.28
Download PDF
⟨ Previous Next ⟩

Abstract

A rare case of ruptured aneurysm associated with multiple $A_1$ fenestrations resembling plexiform network was demonstrated by 3D angiography. A 56-year-old female presented with a ruptured aneurysm in the $A_2$ segment of the left distal anterior cerebral artery associated with the right $A_1$ fenestration. The ruptured aneurysm was occluded with surgical neck clipping via interhemispheric approach without neurological deficit. Plexiform fenestrations of the right distal $A_1$. opposite side to the left ruptured $A_2$ aneurysm, were clearly visible on postoperative 3D angiography. Our case may strongly support the theory described by Paget, namely that a remnant of the plexiform anastomosis between the primitive olfactory artery and $A_1$ segment is the source of such fenestration.

Keywords

References

  1. Baptista AG : studies on the arteries of the brain. II. The anterior cerebral artery: some anatomic features and their clinical implications. Neurology 13 : 825-835, 1963 https://doi.org/10.1212/WNL.13.10.825
  2. Fawcett E, Blachford JV : The circle of Willis : an examination of 700 specimens. J Anat Physiol 40 : 63-70, 1905
  3. Friedlander RM, Ogilvy CS : Aneurysmal subarachnoid hemorrhage in a patient with bilateral A1 fenestrations associated with an azygos anterior cerebral artery. Case report and literature review. J Neurosurg 84 : 681-684, 1996 https://doi.org/10.3171/jns.1996.84.4.0681
  4. Fujimoto Y, Yamanaka K, Nakajima Y, Yoshimura K, Yoshimine T : Ruptured aneurysm arising from the proximal end of an azygos anterior cerebral artery. Neurol Med Chir (Tokyo) 44 : 242-244, 2004 https://doi.org/10.2176/nmc.44.242
  5. Futami K, Yamashita J, Higashi S : Do cerebral aneurysms originate at the site of medial defects? Microscopic examinations of experimental aneurysms at the fenestration of the anterior cerebral artery in rats. Surg Neurol 50 : 141-146, 1998 https://doi.org/10.1016/S0090-3019(97)00154-7
  6. Kachhara R, Nair S, Gupta AK : Fenestration of the proximal anterior cerebral artery (A1) with aneurysm manifesting as subarachnoid hemorrhage--case report. Neurol Med Chir (Tokyo) 38 : 409- 412, 1998 https://doi.org/10.2176/nmc.38.409
  7. Krayenbuhl HA, Yasargil MG : Cerebral Angiography, ed 2. New York : Thieme Medical Publishers, 1968, pp38-40
  8. Minakawa T, Kawamata M, Hayano M, Kawakami K : Aneurysms associated with fenestrated anterior cerebral arteries. Report of four cases and review of literature. Surg Neurol 24 : 284-288, 1985 https://doi.org/10.1016/0090-3019(85)90040-0
  9. Padget DH : The development of the cranial arteries in the human embryo. Contrib Embryol 32 : 205-262, 1948
  10. San-Galli F, Leman C, Kien P, Khazaal J, Phillips SD. Guérin J : Cerebral arterial fenestration associated with intracranial saccular aneurysms. Neurosurgery 30 : 279-283, 1992 https://doi.org/10.1227/00006123-199202000-00026
  11. Teal JS, Rumbaugh CL, Bergeron RT, Segall HD : Angiographic demonstration of fenestrations of the intradural intracranial arteries. Radiology 106 : 123-126, 1973 https://doi.org/10.1148/106.1.123
  12. Von Mitterwallner F : Statistical studies on variations of the basal cerebral vessels. Acta Anat (Basel) 24 : 51-87, 1955 340 https://doi.org/10.1159/000141019

Cited by

  1. Bilateral A1 fenestrations: Report of two cases and literature review vol.3, pp.None, 2008, https://doi.org/10.4103/2152-7806.94928
  2. Persistent Primitive Olfactory Artery in Serbian Population vol.2013, pp.None, 2013, https://doi.org/10.1155/2013/903460
  3. Cerebral Arterial Fenestrations vol.20, pp.3, 2008, https://doi.org/10.15274/inr-2014-10027