Angiographic and Histologic Changes in Infundibular Widening of the Posterior Communicating Artery

Abstract

The proximal part of the posterior communicating artery is often funnelshaped at its origin from the carotid siphon and may vary considerably in size and outline (ref. 4, Fig. I). In some cases in which the posterior communicating artery has not been filled, a broad-based varying bulge in the wall of the carotid siphon may be evident at the site where the posterior communicating artery arises (ref. 4, Fig. 2). A survey ofa normal material of 1020 angiographies (angiographies without evidence of other vascular changes) revealed bulging of the vessel wall at the typical site in 67 cases (SALTZMAN). Approximately the same incidence was established in a material comprising 223 cases of intracranial expansive processes and 118 cases of arterial aneurysm in the carotid region. The figures correspond to ten per cent of the carotid angiographies in which the posterior cerebral artery was not demonstrated. The appearance of the bulge corresponded in many cases with the funnel-shaped proximal part of the posterior com-

Manejo y tratamiento microquirúrgico de las dilataciones infundibulares de la arteria comunicante posterior: Serie de nueve casos y revisión de la literatura

“…Sin embargo, existen pocos datos histopatológicos de las DI y los resultados son contradictorios al faltar estudios amplios y sistemáticos. Así, frente a los resultados de Epstein et al 8 , quienes estudian siete DI no rotas encontradas en autopsias y concluyen indicando categóricamente que en todas ellas la morfología de la pared vascular era normal, Hassler y Saltzmann 11 también estudiando siete casos no rotos de autopsia encontraron defectos en la capa media en siete y destrucción en la elástica interna en uno. En esta misma línea, se han descrito cambios murales en DI rotas.…”

Familial intracranial aneurysm and infundibular widening

“…[21] Its significance, particularly from the point of view of it being pre-aneurysmal, remains uncertain. Hassler and Saltzman [5] looked at the histology of 21 cases of infundibular widening and found that a significant proportion demonstrated defects in the internal elastic lamina as well as defects in the media, such changes being typical of aneurysm. They therefore concluded that the condition is pre-aneurysmal.…”

“…Two series of histological studies [5,6] are entirely contradictory one suggesting that the condition is pre-aneurysmal, the other denying this. Seven cases of progression of infundibular widening to true aneurysm have previously been described in the literature [7][8][9][10][11][12][13].…”

Successful Treatment of a Ruptured Enlarged Infundibular Widening of the Posterior Communicating Artery. Case Report.

“…14) The incidence of infundibular widening is about 5-17% on carotid angiography, and increases with age. 4,8,12,15) Infundibular widening usually does not rupture, but has caused fatal subarachnoid hemorrhage (SAH) 1,12) and development of cerebral aneurysm. 3,10,11,17,18) Here, we describe the successful treatment of a case of ruptured enlarged infundibular widening.…”