Bilateral Infraoptic Origin of Anterior Cerebral Arteries: A Rare Anomaly and its Embryological and Clinical Significance

Chakraborty, Santanu; Fanning, Niall; Lee, S. K.; terBrugge, Karel G.

doi:10.1177/159101990601200210

Cited by 15 publications

(7 citation statements)

References 10 publications

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“…Later on, the origin of the anterior OA migrates caudally toward the optic canal, and the arterial segment between the new origin and the ACA regresses. Failure of regression (with regression of the supraoptic A1 segment) leads to this anomaly . This theory explains why, in some cases, the infraoptic ACAs have the same origin as the OA.…”

Section: Classification Of Normal Variantsmentioning

confidence: 97%

Anomalies and Normal Variants of the Cerebral Arterial Supply: A Comprehensive Pictorial Review with a Proposed Workflow for Classification and Significance

Hakim

Gralla

Rozeik³

et al. 2017

Journal of Neuroimaging

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Cerebral arteries may exhibit a wide range of variation from normal anatomy, which can be incidentally discovered during imaging. Knowledge of such variants is crucial to differentiate them from pathologies, to understand the etiology of certain pathologies directly related to a vascular variant, and to depict the changes in collateral circulation in patients with certain variants. Detection of particular variants may lead to the discovery of other nonvascular or vascular anomalies, especially aneurysms, and may also affect planning of endovascular or neurosurgical interventions. In this review, we summarize the variants and anomalies of cerebral arteries seen on cross-sectional imaging classified by a morphological approach and categorize their significance from a clinical perspective. This structured review is intended to serve as a guide for daily use in clinical practice.

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Section: Classification Of Normal Variantsmentioning

confidence: 97%

Anomalies and Normal Variants of the Cerebral Arterial Supply: A Comprehensive Pictorial Review with a Proposed Workflow for Classification and Significance

Hakim

Gralla

Rozeik³

et al. 2017

Journal of Neuroimaging

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“…The proximal infraoptic A1 segment of the ACA left the intradural ICA near the level of the ophthalmic artery [ 14 ]. The ICA bifurcation in such cases is usually located at the proximal dural ring, at, above or below the level of origin of the ophthalmic artery [ 7 ]. Such proximal infraoptic A1 segments were rarely found leaving the extradural ICA [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Such proximal infraoptic A1 segments were rarely found leaving the extradural ICA [ 14 ]. Bilateral proximal infraoptic A1 segments of the ACAs were found arising inferior to the optic strut [ 7 ]. Few cases of bilateral proximal infraoptic A1 segments of the ACAs were reported until recently [ 4 , 5 , 7 , 13 , 15 , 16 , 17 , 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Infraoptic A1 segments of the ACA were found to originate from a low bifurcation of the ICA (a bifurcation of the proximal intradural segment of the ICA); such infraoptic A1 segments have a horizontal–medial course below the ipsilateral optic nerve, and further turn superiorly on the anterior side of the optic chiasm [ 4 , 5 , 6 , 7 ]. Such infraoptic A1 segments could even pierce the ipsilateral optic tract [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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The Infraoptic or Infrachiasmatic Course of the Anterior Cerebral Artery Emerging an Elongated Internal Carotid Artery

et al. 2022

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(1) Background: The normal A1 segment of the anterior cerebral artery (ACA) has a supraoptic course. The proximal infraoptic course of an A1 segment leaving the internal carotid artery (ICA) near the origin of the ophthalmic artery is a rare possibility. This study aimed to determine the prevalence and detailed anatomy of infraoptic A1 segments. (2) Methods: We retrospectively studied 145 computed tomography angiograms from 92 male and 53 female cases, with ages varying from 61 to 78 y.o. (3) Results: In 21/145 cases, infraoptic or infrachiasmatic horizontal-medial courses of A1 segments that emerged distally from the ICA were found. Distal infraoptic A1 segments were bilateral in 16/145 cases and unilateral in 3/145 cases. Infrachiasmatic A1 segments were found bilaterally in 2/145 male cases. All the infraoptic/infrachiasmatic A1 segments left long ICAs with low bifurcations. In 7/34 sides with distal infraoptic or infrachiasmatic A1 segments, supracarotid courses were present. In one female, the right A1 segment had an anterior supraclinoid, supracarotid and infraoptic course. In two female cases with a bilateral distal infraoptic A1, the segment was almost contacting the respective posterior cerebral artery. (4) Conclusions: In cases with dolicho(ectatic) ICAs, the A1 segments could have infraoptic and supracarotid courses the neurosurgeons should be aware of.

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“…7–10) Infraoptic course ACA is considered as a persistence of embryonal arteries. Although cerebral aneurysms associated with infraoptic course ACA have been reported, 10) there has been no case of dissecting aneurysm in the A1 segment associated with infraoptic course ACA.…”

Section: Introductionmentioning

confidence: 99%

Dissecting Aneurysm at the Proximal Segment of the Anterior Cerebral Artery Associated with Infraoptic Course Anterior Cerebral Artery

Kawaji¹,

Amano²,

Hiramatsu³

et al. 2014

NMC Case Report Journal

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A 48-year-old man presented a subarachnoid hemorrhage caused by a rupture of a dissecting aneurysm at the proximal segment (A1 segment) of the right anterior cerebral artery (ACA). He also had an anomalous artery named infraoptic course ACA and an agenesis of the contralateral ACA A1 segment. Balloon occlusion test at the bifurcation of the right internal carotid artery demonstrated that the distal segments of the bilateral ACAs were perfused through the infraoptic course ACA. Therefore, we surgically trapped the A1 segment including the aneurysm. The patient got discharged without any neurological deficit. Natural course of ACA dissecting aneurysms is unclear because of rarity of the disease and treatment strategy is still controversial. Most of the dissecting aneurysms in the A1 segment are surgically treated, because they often present with massive hemorrhage and poor prognosis. In the present case, the contralateral A1 segment was absent but trapping of the dissecting aneurysm could be achieved without vascular reconstruction (e.g., bypass surgery) because of the presence of the infraoptic course ACA.

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Bilateral Infraoptic Origin of Anterior Cerebral Arteries: A Rare Anomaly and its Embryological and Clinical Significance

Cited by 15 publications

References 10 publications

Anomalies and Normal Variants of the Cerebral Arterial Supply: A Comprehensive Pictorial Review with a Proposed Workflow for Classification and Significance

Anomalies and Normal Variants of the Cerebral Arterial Supply: A Comprehensive Pictorial Review with a Proposed Workflow for Classification and Significance

The Infraoptic or Infrachiasmatic Course of the Anterior Cerebral Artery Emerging an Elongated Internal Carotid Artery

Dissecting Aneurysm at the Proximal Segment of the Anterior Cerebral Artery Associated with Infraoptic Course Anterior Cerebral Artery

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