Anterior Choroidal Artery Supply to the Posterior Cerebral Artery Distribution: Embryological Basis and Clinical Implications

Anterior Choroidal Artery Supply to the Posterior Cerebral Artery Distribution: Embryological... AbstractOBJECTIVE AND IMPORTANCE:We report four cases of anomalous anterior choroidal artery supply to the temporal, parietal, and occipital cortical regions normally supplied by branches of the posterior cerebral artery. Three of these cases were associated with significant intracranial vascular pathology. We examine the embryo- logical basis for the anomalous vascular anatomy to emphasize the potential variability of the anterior choroidal artery distribution and illustrate the spectrum of this variability angiographically. These variants may also have significant implications for surgical and endovascular treatment.CLINICAL PRESENTATION:One patient was diagnosed with an arteriovenous malformation, and two patients were diagnosed with aneurysms, one of which presented with a subarachnoid hemorrhage.INTERVENTION:The patient with the arteriovenous malformation underwent preoperative embolization and surgical resection, one patient with an aneurysm was treated via surgical clipping, and the other aneurysm underwent endovascular coiling.CONCLUSION:This group of patients illustrates an underemphasized but potentially important vascular anomaly. Phylogeny and embryology of the intracerebral vessels suggest a mechanism related to transposed distributions. Careful attention must be directed to the microvascular anatomy of the intracerebral circulation so that these anomalies are recognized and, if necessary, factored into surgical and interventional planning http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Anterior Choroidal Artery Supply to the Posterior Cerebral Artery Distribution: Embryological Basis and Clinical Implications

Anterior Choroidal Artery Supply to the Posterior Cerebral Artery Distribution: Embryological Basis and Clinical Implications

Anterior Choroidal Artery Supply to the Posterior Cerebral Artery Distribution: Embryological Basis and Clinical Implications John M. Abrahams, M.D., Robert W . Hurst, M.D., Linda J. Bagley, M.D., Eric L. Zager, M.D. Department of Neurosurgery, Hospital of the U niversity of Pennsylvan ia, Philadelphia, Pennsylvania O B JE C T IV E A N D IM P O R T A N C E : W e report four cases of anomalous anterior choroidal artery supply to the temporal, parietal, and occipital cortical regions norm ally supplied by branches of the posterior cerebral artery. Three of these cases w ere associated w ith significant intracranial vascular pathology. W e examine the embryo- logical basis for the anomalous vascular anatom y to emphasize the potential variab ility of the anterior choroidal artery distribution and illustrate the spectrum of this variab ility angiographically. These variants may also have significant im plications for surgical and endovascular treatm ent. C L IN IC A L P R E SE N T A T IO N : O ne patient was diagnosed w ith an arteriovenous m alform ation, and tw o patients were diagnosed w ith aneurysms, one of w hich presented w ith a subarachnoid hem orrhage. IN T E R V E N T IO N : The patient w ith the arteriovenous m alform ation underw ent preoperative embolization and surgical resection, one patient w ith an aneurysm was treated via surgical clipping, and the other aneurysm underwent endovascular coiling. C O N C L U S IO N : This group of patients illustrates an underemphasized but potentially im portant vascular anomaly. Phylogeny and em bryology of the intracerebral vessels suggest a mechanism related to transposed distributions. Careful attention must be directed to the m icrovascular anatom y of the intracerebral circulation so that these anomalies are recognized and, if necessary, factored into surgical and interventional planning. (N e u r o s u r g e r y 4 4 : 1 3 0 8 - 1 3 1 4 , 1999) Key words: Aneurysm, Anterior choroidal artery, Arteriovenous...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199906000-00083
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE AND IMPORTANCE:We report four cases of anomalous anterior choroidal artery supply to the temporal, parietal, and occipital cortical regions normally supplied by branches of the posterior cerebral artery. Three of these cases were associated with significant intracranial vascular pathology. We examine the embryo- logical basis for the anomalous vascular anatomy to emphasize the potential variability of the anterior choroidal artery distribution and illustrate the spectrum of this variability angiographically. These variants may also have significant implications for surgical and endovascular treatment.CLINICAL PRESENTATION:One patient was diagnosed with an arteriovenous malformation, and two patients were diagnosed with aneurysms, one of which presented with a subarachnoid hemorrhage.INTERVENTION:The patient with the arteriovenous malformation underwent preoperative embolization and surgical resection, one patient with an aneurysm was treated via surgical clipping, and the other aneurysm underwent endovascular coiling.CONCLUSION:This group of patients illustrates an underemphasized but potentially important vascular anomaly. Phylogeny and embryology of the intracerebral vessels suggest a mechanism related to transposed distributions. Careful attention must be directed to the microvascular anatomy of the intracerebral circulation so that these anomalies are recognized and, if necessary, factored into surgical and interventional planning

Journal

NeurosurgeryOxford University Press

Published: Jun 1, 1999

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