Abstract
Fenestrations (segmental duplications) of the intracranial arteries are rare anomalies that have been associated with aneurysms. Fenestrations of the supraclinoid ICA are extremely rare, with only a few reported cases. We present a supraclinoid ICA fenestration, which on axial CTA images initially mimicked an aneurysm, but was correctly delineated as a fenestration on multiplanar reformatted and 3D reconstructed images. Confirmation was made with conventional angiography. To our knowledge, this represents the first time that this rare variant has been identified with cross-sectional imaging. A review of the literature including proposed embryology is provided.
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References
Banach MJ, Flamm ES (1993) Supraclinoid internal carotid artery fenestration with an associated aneurysm. Case report. J Neurosurg 79(3):438–441
Findlay JM, Chui M, Muller PJ (1987) Fenestration of the supraclinoid internal carotid artery. Can J Neurol Sci 14(2):159–161
Finlay HM, Canham PB (1994) The layered fabric of cerebral artery fenestrations. Stroke 25(9):1799–1806
Gailloud P, Clatterbuck RE, Fasel JH, Tamargo RJ, Murphy KJ (2004) Segmental agenesis of the internal carotid artery distal to the posterior communicating artery leading to the definition of a new embryologic segment. Am J Neuroradiol 25(7):1189–1193
Gomes FB, Dujovny M, Umansky F, Berman SK, Diaz FG, Ausman JI, Mirchandani HG, Ray WJ (1986) Microanatomy of the anterior cerebral artery. Surg Neurol 26:129–141
Hattori T, Kobayashi H (1992) Fenestration of the supraclinoid internal carotid artery associated with carotid bifurcation aneurysm. Surg Neurol 37(4):284–288
Ionete C, Omojola MF (2006) MR angiographic demonstration of bilateral duplication of the extracranial vertebral artery: unusual course and review of the literature. Am J Neuroradiol 27(6):1304–1306
Katsuta T, Matsubara T, Fujii K (1993) Fenestration of the supraclinoid internal carotid artery. Neuroradiology 35(6):461
Lasjaunias P, Santoyo-Vazquez A (1984) Segmental agenesis of the internal carotid artery: angiographic aspects with embryological discussion. Anat Clin 6(2):133–141
Lasjaunias P, Berenstein A, ter Brugge KG (2001) Surgical neuroangiography: 1 clinical vascular anatomy and variations, 2nd edn, vol 577. pp 617–619
Meder JF, Blustajn J, Trystram D, Godon-Hardy S, Devaux B, Zuber M, Fredy D (1997) Radiologic anatomy of segmental agenesis of the internal carotid artery. Surg Radiol Anat 19(6):385–394
Ng PP, Steinfort B, Stoodley MA (2006) Internal carotid artery fenestration with dual aneurysms. Case illustration. J Neurosurg 104(6):979
Padget DH (1948) The development of the cranial arteries in the human embryo. Contrib Embryol 212:207–261
Sanders WP, Sorek PA, Mehta BA (1993) Fenestration of intracranial arteries with special attention to associated aneurysms and other anomalies. Am J Neuroradiol 14(3):675–680
Serizawa T, Saeki N, Yamaura A (1997) Microsurgical anatomy and clinical significance of the anterior communicating artery and its perforating branches. Neurosurgery 40(6):1211–1216
Takano S, Saitoh M, Miyasaka Y, Yada K, Takagi H (1991) Fenestration of the intracranial internal carotid artery—case report. Neurol Med Chir (Tokyo) 31(11):740–742
Tao X, Yu XJ, Bhattarai B, Li TH, Jin H, Wei GW, Ming JS, Ren W, Jiong C (2006) Microsurgical anatomy of the anterior communicating artery complex in adult Chinese heads. Surg Neurol 65(2):155–161
Uchino A, Kato A, Abe M, Kudo S (2001) Association of cerebral arteriovenous malformation with cerebral arterial fenestration. Eur Radiol 11(3):493–496
Uchino A, Kato A, Takase Y, Kudo S (2001) Basilar artery fenestrations detected by MR angiography. Radiat Med 19(2):71–74
Wollschlaeger G, Wollschlaeger PB, Lucas FV, Lopez VF (1967) Experience and result with postmortem cerebral angiography performed as routine procedure of the autopsy. Am J Roentgenol Radium Ther Nucl Med 101(1):68–87
Yock DH Jr (1984) Fenestration of the supraclinoid internal carotid artery with rupture of associated aneurysm. Am J Neuroradiol 5(5):634–636
Acknowledgments
The authors wish to thank Pierre Lasjaunias and Karel ter Brugge for reviewing the case and providing insights.
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Bharatha, A., Fox, A.J., Aviv, R.I. et al. CT angiographic depiction of a supraclinoid ICA fenestration mimicking aneurysm, confirmed with catheter angiography. Surg Radiol Anat 29, 317–321 (2007). https://doi.org/10.1007/s00276-007-0205-5
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DOI: https://doi.org/10.1007/s00276-007-0205-5