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Intracranial arterial fenestrations: frequency on CT angiography and association with other vascular lesions

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Abstract

Fenestrations (segmental duplications) of the intracranial arteries are rare anomalies, felt to result from incomplete fusion of primitive embryologic vessels. They have been associated with aneurysms and other vascular lesions. The rate of fenestrations based on published angiographic series has been much lower than that at cadaveric series. The purpose of this study is to determine the frequency of fenestrations and associated vascular lesions at CTA. A total of 504 sequential CTA studies from 2005 to 2006 were retrospectively reviewed for the presence of fenestrations, aneurysms and other vascular lesions. Fenestrations were present in 53 patients (11%). Their frequency was not significantly different in patients referred for aneurysm indications, when compared to those referred for non-aneurysm indications. As expected, there was a much higher frequency of aneurysms in the former group. Associated vascular lesions were relatively uncommon. Aneurysms were present at the fenestration site in three patients, and remote from the fenestration site in eight. One fenestration patient with an associated aneurysm at the fenestration site also had an AVM remote from the fenestration. The frequency of fenestrations in this study was higher than in previously published radiologic studies, suggesting that fenestrations are relatively common, and may be more frequently visualized using cross-sectional imaging. Association with aneurysms and other vascular lesions was relatively uncommon. Our results do not support the theory that fenestrations predispose a patient to aneurysms or vascular malformations remote from the site of the fenestration. Although the association of aneurysms at the site of fenestrations is well documented, our results do not show an overall higher rate of aneurysm formation in patients with fenestrations compared to those without.

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References

  1. Adachi B (1928) Das arteriensystem der japaner vol I. Maruzen, Kyoto, pp 124–134

  2. Banach MJ, Flamm ES (1993) Supraclinoid internal carotid artery fenestration with an associated aneurysm: case report. J Neurosurg 79(3):438–441

    Article  PubMed  CAS  Google Scholar 

  3. Bharatha A, Fox AJ, Aviv RI, Symons SP (2007) CT angiographic depiction of a supraclinoid ica fenestration mimicking aneurysm, confirmed with catheter angiography. Surg Radiol Anat 29:317–321

    Article  PubMed  Google Scholar 

  4. Campos J, Fox AJ, Vinuela F, Lylyk P, Ferguson GG, Drake CG, Peerless SJ (1987) Saccular aneurysms in basilar artery fenestration. AJNR Am J Neuroradiol 8(2):233

    PubMed  CAS  Google Scholar 

  5. Findlay JM, Chui M, Muller PJ (1987) Fenestration of the supraclinoid internal carotid artery. Can J Neurol Sci 14(2):159–161

    PubMed  CAS  Google Scholar 

  6. Finlay HM, Canham PB (1994) The layered fabric of cerebral artery fenestrations. Stroke 25(9):1799–1806

    PubMed  CAS  Google Scholar 

  7. 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

    Article  PubMed  CAS  Google Scholar 

  8. Ionete C, Omojola MF (2006) MR angiographic demonstration of bilateral duplication of the extracranial vertebral artery: unusual course and review of the literature. AJNR Am J Neuroradiol 27(6):1304–1306

    PubMed  CAS  Google Scholar 

  9. Kowada M, Yamaguchi K, Takahashi H (1972) Fenestration of the vertebral artery with a review of 23 cases in Japan. Radiology 103(2):343–346

    PubMed  CAS  Google Scholar 

  10. Lasjaunias P, Berenstein A, ter Brugge KG (2001) Surgical neuroangiography: 1 clinical vascular anatomy and variations, 2nd edn, Springer, Heidelberg, pp 577, 617–619

  11. Padget DH (1948) The development of the cranial arteries in the human embryo. Contrib Embryol 212:207–261

    Google Scholar 

  12. Sanders WP, Sorek PA, Mehta BA (1993) Fenestration of intracranial arteries with special attention to associated aneurysms and other anomalies. AJNR Am J Neuroradiol 14(3):675–680

    PubMed  CAS  Google Scholar 

  13. 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

    Article  PubMed  CAS  Google Scholar 

  14. 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

    Article  PubMed  Google Scholar 

  15. Uchino A, Kato A, Abe M, Kudo S (2001) Association of cerebral arteriovenous malformation with cerebral arterial fenestration. Eur Radiol 11(3):493–496

    Article  PubMed  CAS  Google Scholar 

  16. Uchino A, Kato A, Takase Y, Kudo S (2001) Basilar artery fenestrations detected by MR angiography. Radiat Med 19(2):71–74

    PubMed  CAS  Google Scholar 

  17. 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

    PubMed  CAS  Google Scholar 

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Correspondence to Sean P. Symons.

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Bharatha, A., Aviv, R.I., White, J. et al. Intracranial arterial fenestrations: frequency on CT angiography and association with other vascular lesions. Surg Radiol Anat 30, 397–401 (2008). https://doi.org/10.1007/s00276-008-0340-7

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  • DOI: https://doi.org/10.1007/s00276-008-0340-7

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