Aberrant Origin of the Distal Anterior Cerebral Artery from the Middle Cerebral Artery Related to Obstruction of Bilateral Proximal Anterior Cerebral Arteries: A Case Report

Article ID: e130223213636 Pages: 4

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Abstract

Background: Aberrant origin of the distal anterior cerebral artery (ACA) arising from the middle cerebral artery (MCA) is extremely rare.

Case Presentation: A 74-year-old woman with a sudden onset of left-sided weakness was admitted to the emergency department. Angiography revealed an unusual course of the distal ACA originating from the MCA with bilateral obstruction of the proximal segment of the ACA and simultaneous occurrence of infarction in the ACA and MCA territories.

Conclusion: Knowledge of a rare vascular variation or anomaly could help understand brain imaging, which has an unusual involvement of vascular territories, performed in patients with acute ischemic stroke.

Graphical Abstract

[1]
Stefani MA, Schneider FL, Marrone ACH, Severino AG, Jackowski AP, Wallace MC. Anatomic variations of anterior cerebral artery cortical branches. Clin Anat 2000; 13(4): 231-6.
[http://dx.doi.org/10.1002/1098-2353(2000)13:4<231:AID-CA1>3.0.CO;2-T] [PMID: 10873213]
[2]
Dimmick SJ, Faulder KC. Normal variants of the cerebral circulation at multidetector CT angiography. Radiographics 2009; 29(4): 1027-43.
[http://dx.doi.org/10.1148/rg.294085730] [PMID: 19605654]
[3]
Krabbe-Hartkamp MJ, van der Grond J, de Leeuw FE, et al. Circle of Willis: morphologic variation on three-dimensional time-of-flight MR angiograms. Radiology 1998; 207(1): 103-11.
[http://dx.doi.org/10.1148/radiology.207.1.9530305] [PMID: 9530305]
[4]
Cilliers K, Page BJ. Review of the anatomy of the distal anterior cerebral artery and its anomalies. Turk Neurosurg 2016; 26(5): 653-61.
[PMID: 27337235]
[5]
Uchino A, Nomiyama K, Takase Y, Kudo S. Anterior cerebral artery variations detected by MR angiography. Neuroradiology 2006; 48(9): 647-52.
[http://dx.doi.org/10.1007/s00234-006-0110-3] [PMID: 16786350]
[6]
Cilliers K, Page BJ. Detailed description of the anterior cerebral artery anomalies observed in a cadaver population. Ann Anat 2016; 208: 1-8.
[http://dx.doi.org/10.1016/j.aanat.2016.04.036] [PMID: 27237980]
[7]
Gunnal SA, Wabale RN, Farooqui MS. Variations of anterior cerebral artery in human cadavers. Neurol Asia 2013; 18: 249-59.
[8]
Pendharkar H, Venkateshappa BM, Prasad C. Variant course of bilateral anterior cerebral artery in semilobar holoprosencephaly. Surg Radiol Anat 2015; 37(10): 1195-8.
[http://dx.doi.org/10.1007/s00276-015-1498-4] [PMID: 26027553]
[9]
van Overbeeke JJ, Hillen B, Vermeij-Keers C. The arterial pattern at the base of arhinencephalic and holoprosencephalic brains. J Anat 1994; 185(Pt 1): 51-63.
[PMID: 7559115]
[10]
Okahara M, Kiyosue H, Mori H, Tanoue S, Sainou M, Nagatomi H. Anatomic variations of the cerebral arteries and their embryology: A pictorial review. Eur Radiol 2002; 12(10): 2548-61.
[http://dx.doi.org/10.1007/s00330-001-1286-x] [PMID: 12271398]