Cross-Flow at Anterior Communicating Artery and Implication in Cerebral Aneurysm Formation

2009 ◽  
Author(s):  
Liang-Der Jou ◽  
Michel E. Mawad
Keyword(s):  
Cerebral Aneurysm ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Cross Flow ◽  
Lateral Flow ◽  
Anterior Communicating Artery ◽  
Ruptured Aneurysms ◽  
Aneurysm Formation ◽  
The Right

The anterior communication artery (ACOM) connects the right and left anterior cerebral artery and establishes contra-lateral flow, permiting perfusion of brain at both sides. While the artery itself is very short in length and small in size, 35% of ruptured aneurysms are found to form at the ACOM [1] and these aneurysms also rupture when they are small [2].

Abstract TP93: Early Morphological Changes in Cerebral Arteries of Cerebral Aneurysm Rupture Model Rats

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Hidetsugu Maekawa ◽  
Takeshi Miyamoto ◽  
Keiko T Kitazato ◽  
Kenji Yagi ◽  
Yoshiteru Tada ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Cerebral Aneurysm ◽  
Cerebral Artery ◽  
Morphological Changes ◽  
Cerebral Aneurysms ◽  
Aneurysm Rupture ◽  
Anterior Communicating Artery ◽  
Artery Ligation ◽  
Ruptured Aneurysms ◽  
The Right

Introduction: To study the pathomechanisms of cerebral aneurysms, we developed a rat model of cerebral aneurysm rupture. In order, the ruptured aneurysms were located at the P1 segment of the left posterior cerebral artery, on the anterior cerebral artery (ACA), the right internal carotid artery (ICA), the right middle cerebral artery (MCA), and the anterior communicating artery (AcomA). We investigated the early morphological changes in these arteries that preceded aneurysm formation. Methods: We subjected 10-week-old Sprague-Dawley rats to bilateral ovariectomy and modified carotid artery ligation. They were fed a high salt diet. Two weeks later, the bilateral posterior renal arteries were ligated. Vascular corrosion casts were created 2 weeks after renal artery ligation (n=11) and the morphological features were compared on casts from these- and sham rats (n=3) using a scanning electron microscope. Results: The diameter of the left- was larger than of the right P1 in all rats with hypertension and estrogen deficiency. Endothelial changes were predominantly seen in the AcomA and the left P1. In 5 rats we observed small protrusions without loss of endothelial imprints suggesting local loss of internal elastic lamina in the left P1 where ruptured aneurysms were frequently formed. No aneurysms formed at the right ACA-olfactory artery (OA) bifurcation within 2 weeks after aneurysm induction. None of these changes were found in the controls. As ACA-OA aneurysms were frequently seen at 3 months but never ruptured, the pathophysiology of such, and of aneurysms formed at other sites may be different. Conclusion: We first demonstrate the initial morphological changes that occurred as early as two weeks after aneurysm induction in rats. Early intervention for hypertension and endothelial damage may be beneficial in the management of cerebral aneurysms.

scholarly journals Fenestrated Anterior Cerebral Artery with Associated Arterial Anomalies

2008 ◽  
Vol 14 (4) ◽  
pp. 441-445 ◽  
Author(s):  
S.J. Dimmick ◽  
K.C. Faulder
Keyword(s):  
Cerebral Aneurysm ◽  
Clinical Significance ◽  
Cerebral Artery ◽  
Cerebral Circulation ◽  
Anterior Cerebral Artery ◽  
Case Reports ◽  
Vascular Anomalies ◽  
Review Of The Literature ◽  
Aneurysm Formation ◽  
Arterial Anomalies

Fenestration of the A2 segment is extremely rare. Cerebrovascular fenestration may be associated with an increased incidence of cerebral aneurysm and other vascular anomalies. Two case reports are presented which identify a fenestration of the A2 segment and other normal variations of the intra-cerebral circulation. A review of the literature has been undertaken to determine the prevalence and embryology of anterior cerebral artery fenestrations, their clinical significance and the association with aneurysm formation and other intracranial vascular anomalies.

scholarly journals Balloon-Assisted Cannulation for Difficult Anterior Cerebral Artery Access

2017 ◽  
Vol 7 (1-2) ◽  
pp. 48-52
Author(s):  
Varun Naragum ◽  
Mohamad AbdalKader ◽  
Thanh N. Nguyen ◽  
Alexander Norbash
Keyword(s):  
Cerebral Artery ◽  
Paradigm Shift ◽  
Intracranial Aneurysms ◽  
Anterior Cerebral Artery ◽  
Endovascular Coiling ◽  
Anterior Communicating Artery ◽  
Surgical Clipping ◽  
Ruptured Aneurysms ◽  
Common Location ◽  
Proximal Middle Cerebral Artery

The anterior communicating artery is a common location for intracranial aneurysms. Compared to surgical clipping, endovascular coiling has been shown to improve outcomes for patients with ruptured aneurysms and we have seen a paradigm shift favoring this technique for treating aneurysms. Access to the anterior cerebral artery can be challenging, especially in patients with tortuous anatomy or subarachnoid hemorrhage or in patients presenting with vasospasm. We present a technique for cannulating the anterior cerebral artery using a balloon inflated in the proximal middle cerebral artery as a rebound surface.

scholarly journals Anatomical variations of circle of Willis - a cadaveric study

2017 ◽  
Vol 4 (4) ◽  
pp. 1249 ◽  
Author(s):  
Ramanuj Singh ◽  
Ajay Babu Kannabathula ◽  
Himadri Sunam ◽  
Debajani Deka
Keyword(s):  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Anterior Part ◽  
Cerebral Arteries ◽  
Anatomical Variations ◽  
Circle Of Willis ◽  
Anterior Communicating Artery ◽  
Surgical Interventions ◽  
Collateral Channel ◽  
The Right

Background: The circle of Willis (CW) is a vascular network formed at the base of skull in the interpeduncular fossa. Its anterior part is formed by the anterior cerebral artery, from either side. Anterior communicating artery connects the right and left anterior cerebral arteries. Posteriorly, the basilar artery divides into right and left posterior cerebral arteries and each join to ipsilateral internal carotid artery through a posterior communicating artery. Anterior communicating artery and posterior communicating arteries are important component of circle of Willis, acts as collateral channel to stabilize blood flow. In the present study, anatomical variations in the circle of Willis were noted.Methods: 75 apparently normal formalin fixed brain specimens were collected from human cadavers. 55 Normal anatomical pattern and 20 variations of circle of Willis were studied. The Circles of Willis arteries were then colored, photographed, numbered and the abnormalities, if any, were noted.Results: Twenty variations were noted. The most common variation observed is in the anterior communicating artery followed by some other variations like the Posterior communicating arteries, Anterior cerebral artery and posterior cerebral artery (PCA) was found in 20 specimens.Conclusions: Knowledge on of variations in the formation of Circle of Willis, all surgical interventions should be preceded by angiography. Awareness of these anatomical variations is important in the neurovascular procedures.

scholarly journals The experience of simultaneous endovascular occlusion of arteriovenous malformation and saccular aneurism in a parturient woman

2020 ◽  
Vol 30 (4) ◽  
pp. 79-87
Author(s):  
D.V. Shchehlov ◽  
S.V. Konotopchyk ◽  
I.N. Bortnyk ◽  
O.E. Svyrydiuk ◽  
M.Yu. Mamonova
Keyword(s):  
Arteriovenous Malformation ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Parietal Lobe ◽  
Endovascular Embolization ◽  
Saccular Aneurysm ◽  
Anterior Communicating Artery ◽  
Parturient Woman ◽  
Left Lateral Ventricle ◽  
The Right

The clinical case of simultaneous endovascular bloodstream exclusion of arteriovenous malformation and saccular aneurysm in parturient woman is presented. Onyx liquid adhesive composition and monospiral aneurysm occlusion technique were used. Patient X., 31, was hospitalized to the clinic on the 10th day of the postpartum period. From the anamnesis: twice (at 20th and 27th weeks of pregnancy) patient suffered intraventricular hemorrhage due to the rupture of arteriovenous malformation in the posterior third of the corpus callosum, left lateral ventricle and left parietal lobe of the brain. After the first hemorrhage a conservative treatment tactic was determined, given the high risk of complications associated with the surgical intervention for the mother and fetus. After the second hemorrhage endovascular embolization of malformation was suggested, however, the patient and her husband refused surgery, preferring conservative therapy with subsequent surgical treatment after delivery. In addition to the malformation, according to the data of selective cerebral subtraction angiography multiple cerebral saccular aneurysms of the left Anterior Cerebral – Anterior Communicating Artery and 2 Anterior Cerebral Artery aneurysms (A2-A2, A3-A4-segments) on the right side were diagnosed. Endovascular subtotal embolization of arteriovenous malformation and occlusion of the right Anterior Cerebral Artery (A2-A3-segment) saccular aneurysm were performed during the operation. A control angiographic examination after 3 months showed a complete exclusion of these arteriovenous malformation and saccular aneurysm and disappearance of all aneurysms of the left Anterior Cerebral Artery – Anterior Communicating Artery and right Anterior Cerebral Artery (A3-A4-segment).

scholarly journals Bilateral cerebral infarction associated with severe arteriosclerosis in the A1 segment: a case report

2019 ◽  
Vol 47 (3) ◽  
pp. 1373-1377
Author(s):  
Jing Lin ◽  
Wenbiao Xian ◽  
Rong Lai ◽  
Jiaoxing Li ◽  
Yufang Wang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cerebral Infarction ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Anterior Communicating Artery ◽  
Left Middle Cerebral Artery ◽  
Large Artery ◽  
Anterior Circulation ◽  
The Right ◽  
Left Middle

Large artery atherosclerosis and cardioembolism are the two major subtypes of ischemic stroke. We herein describe a 75-year-old man with acute complete cerebral infarction in the typical territories of the bilateral anterior cerebral artery (ACA) and left middle cerebral artery. Brain magnetic resonance angiography showed that the right A1 segment of the ACA was affected by severe arteriosclerosis and that the right ACA other than the A1 segment was compensated by the left ACA through the anterior communicating artery. Acute cardioembolism only occluded the left anterior circulation but simultaneously blocked the right ACA due to decompensation. We presume that the bilateral cerebral infarctions were caused by chronic atherosclerosis and acute cardioembolism.

Occlusion of the Anterior Cerebral Artery Mimicking a Cerebral Aneurysm: Clinical Presentation and Literature Review

2021 ◽  
Author(s):  
Yang Liu ◽  
Gaochao Guo ◽  
Zhu Lin ◽  
Liming Zhao ◽  
Juha Hernesniemi ◽  
...  
Keyword(s):  
Literature Review ◽  
Middle Cerebral Artery ◽  
Cerebral Aneurysm ◽  
Moyamoya Disease ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Clinical Presentation ◽  
Disease Patient ◽  
Extensive Literature ◽  
The Right

Abstract Background Intracranial aneurysms may be misdiagnosed with other vascular lesions such as vascular loops, infundibulum, or the stump of an occluded artery (very rare and reported compromising only the middle cerebral artery and the posterior circulation territory). Our aim was to describe a unique case of occlusion of an anterior cerebral artery mimicking a cerebral aneurysm in a probable moyamoya disease patient, and to highlight its clinical presentation, diagnosis, and management, and to perform an extensive literature review. Case A 67-year-old man suffering from recurrent dizziness for 3 months. Previous medical history was unremarkable. Brain magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) demonstrated occlusion of the right middle cerebral artery (MCA) associated with a “probable moyamoya disease” and an aneurysm-like shadow protruding lesion at the anterior communicating artery (AcomA). Perfusion images showed ischemia along the right temporo-occipital lobe. Due to MCA occlusion with perfusion deficits and unspecific symptoms, we offered a right side encephalo-duro-myo-synangiosis (EDMS) and clipping of the AcomA aneurysm in one session. Intraoperatively, there was no evidence of the AcomA aneurysm; instead, this finding corresponded to the stump of the occluded right anterior cerebral artery (A1 segment). This segment appeared to be of yellowish color due to atherosclerosis and lacked blood flow. The patient underwent as previously planned a right side EDMS and the perioperative course was uneventful without the presence of additional ischemic attacks. Conclusion Arterial branch occlusions can sometimes present atypical angiographic characteristics that can mimic a saccular intracranial aneurysm. It is relevant to consider this radiographic differential diagnosis, especially when aneurysm treatment is planned.

scholarly journals An unusual variation in the anterior communicating artery of the circle of Willis in the human brain - a case report

2016 ◽  
Vol 05 (01) ◽  
pp. 039-043
Author(s):  
Farheen A Karim ◽  
J D Sarma ◽  
K L Talukdar
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Human Brain ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Circle Of Willis ◽  
Anterior Communicating Artery ◽  
Interpeduncular Cistern ◽  
The Right ◽  
The Brain

AbstractThis report highlights an unusual variation of Anterior communicating artery of the circle of Willis found during dissection for studying circle of Willis. The brain was carefully extracted out of the skull so that arteries forming the circle of Willis do not get tom. The circle of Willis was identified in the interpeduncular cistern. Fine dissection was done to identify any variations. In this specimen there were double anterior communicating arteries joined in the midline by a short longitudinal segment of artery. Length and external diameters of both the Anterior communicating arteries were measured using Vernier calipers. Also, a medial striate artery (recurrent artery of Heubner) was seen originating from the right anterior cerebral artery just between the junctions of the proximal and distal Anterior communicating arteries with the right Anterior cerebral artery. Knowledge of this variation is valuable to neurosurgeons in planning surgical treatment and has clinical significance in relation to stroke.

Long-term outcome following anterior cerebral artery ligation for ruptured anterior communicating artery aneurysms

1991 ◽  
Vol 74 (1) ◽  
pp. 51-54 ◽  
Author(s):  
William Taylor ◽  
J. Douglas Miller ◽  
Nicholas V. Todd
Keyword(s):  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Artery Aneurysm ◽  
Anterior Communicating Artery ◽  
Artery Ligation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Content Type ◽  
Ruptured Aneurysms

✓ The long-term prognosis (15 years) was determined for 17 patients who had undergone anterior cerebral artery (ACA) ligation as the sole treatment for an anterior communicating artery aneurysm. The number of early and late rebleeds was lower than expected from previously ruptured aneurysms. Late ischemia was not a major complication while late postoperative epilepsy occurred in 19% of survivors. In a review of previously published series, ACA ligation appears to have significantly reduced the rates of both early and late rebleeding. This study helps to define the late results of “conservative” operations for ruptured aneurysms.

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