Imaging detection of cerebral artery fenestrations and their clinical correlation with cerebrovascular diseases

Wu, Xuan; Chen, Xinyuan; Zhu, Jiting; Chen, Qunlin; Li, Zhiwen

doi:10.1016/j.clinimag.2020.01.012

Cited by 14 publications

(25 citation statements)

References 24 publications

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“…[4] The incidence of cerebrovascular fenestration malformation is between 1.13% and 2.1%, [5,6] among which basilar artery fenestration malformation is the most common. [7] According to Wu et al, [5] cerebrovascular fenestration malformations are classified according to shape into slit-like, convex-lens-like, duplication, and irregular types. In the present case, the basilar artery fenestration deformity was considered irregular.…”

Section: Discussionmentioning

confidence: 99%

“…Cerebrovascular fenestration malformation refers to the limited repeated division of cerebral blood vessels into 2 branches before converging again after a certain distance. [ 4 ] The incidence of cerebrovascular fenestration malformation is between 1.13% and 2.1%, [ 5 , 6 ] among which basilar artery fenestration malformation is the most common. [ 7 ]…”

Section: Discussionmentioning

confidence: 99%

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Acute pontine infarction in a patient with 8-shaped basilar artery fenestration malformation: A case report

Zhang

Xing

et al. 2022

Medicine

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Introduction: Cerebrovascular fenestration malformation is a relatively rare vascular dysplasia, and an 8-shaped basilar artery fenestration malformation is even rarer. The characteristics of transcranial Doppler cerebral blood flow in cerebrovascular fenestration malformations have rarely been studied or reported. Patient concerns: A 58-year-old woman presented with hypertension, diabetes, with no history of smoking or drinking. The patient had no relevant family history. The patient experienced left limb weakness for 2 days, which gradually worsened. Diagnosis: Head and neck computed tomography angiography revealed an 8-shaped fenestration deformity of the lower segment of the basilar artery with multiple stenoses of the local vessels. Transcranial Doppler cerebral blood flow examination at a depth of 85 cm revealed an eddy current in the lower segment of the basilar artery. Interventions: Tirofiban was administered intravenously for 3 days and subsequently changed to oral clopidogrel antiplatelet treatment. Outcomes: The modified Rankin Scale score at 3 months after disease onset was 0, indicating that the patient recovered well after treatment. Conclusion: A basilar artery 8-shaped fenestration is extremely rare and has seldom been reported. Cerebral vascular fenestration can lead to an acute cerebral infarction and its pathogenesis may include local hemodynamic abnormalities and thrombosis. Eddy currents can be detected by transcranial Doppler cerebral blood flow examination.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Acute pontine infarction in a patient with 8-shaped basilar artery fenestration malformation: A case report

Zhang

Xing

et al. 2022

Medicine

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“…It is a rare congenital abnormality of blood vessel development that results from incomplete fusion of primitive embryologic vessels 2 . Fenestration has been found more common in the posterior circulation, especially in basilar artery (BA) 3,4 . The rate of BA fenestration has been found to be 0.6% in angiographic examinations and 5% in autopsies 3 .…”

Section: Introductionmentioning

confidence: 99%

“…the posterior circulation, especially in basilar artery (BA). 3,4 The rate of BA fenestration has been found to be 0.6% in angiographic examinations and 5% in autopsies. 3 It was reported that BA fenestration mostly occurs at the lower end of the BA, and few of them can be seen in the mid basilar and distal tip.…”

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confidence: 99%

Hemodynamic effects of size and location of basilar artery fenestrations associated to pathological implications

Tong

Dong

Zhou

et al. 2021

Numer Methods Biomed Eng

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Fenestration is a rare congenital abnormality that refers to a segmental duplication of arteries. It is still not clear about the role of fenestrations in the etiology and pathological evolution of vascular diseases. This study aims to investigate the hemodynamic influence brought by various sizes and locations of fenestration in basilar artery models. A series presumptive fenestration models were established based on a normal basilar artery model with various sizes and locations. Identical boundary conditions were utilized in the computational fluid dynamics simulations and different flow patterns in the fenestration and bifurcation regions were comprehensively analyzed. Wall shear stress (WSS)‐related parameters such as oscillatory shear index (OSI) and aneurysm formation index (AFI) were computed and compared. The value of WSS on fenestration increased by the fenestration's tortuosity, and nearly‐circular fenestration suffered higher WSS than narrow‐strips one. Also, high OSI and low AFI value mainly occurred in the bifurcation region, indicating a high level of turbulence and high risk of aneurysm formation. The location of fenestration mainly changed the impact force of blood flow on the bifurcation and the disorder characteristics of blood flow, while the size of fenestration changed the WSS distribution on the proximal inner wall and bifurcation region of fenestration. In summary, the nearly‐circular fenestration should be stratified carefully which may results in a high risk inducing unfavorable vascular wall remodeling.

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“…Serebral fenestrasyonlar vertebro-baziler sistemde daha fazla olmak üzere, intrakranial arterlerin tüm dallarında görülebilirler (3)(4)(5)(6) . Serebral fenestrasyonların serebral anevrizma, serebrovaskuler hastalık ve arteriovenöz malformasyonlar ile birlikteliği tanımlanmasına karşın neden-sonuç ilişkisi hala net olarak ortaya konamamıştır (5,7,8) .…”

Section: Introductionunclassified

Evaluation the Frequency of Cerebral Arterial Fenestrations and Their Association with Cerebral Aneurysm by CT Angiography

Pekçevik¹,

Pekçevik²

2021

Terh

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Objective: Fenestration is a vascular variation that begins with a common origin, then splits into two parallel luminal channels that rejoins distally. We aim to evalute the frequency of cerebral arterial fenestrations and their association with cerebral aneurysm by computed tomography (CT) angiography. Methods: We retrospectively analyzed cerebral CT angiography of patients obtained between January 2017 and December 2020. Patients older than 18 years-old, without known vascular disease and previous surgery or interventional treatment were included the study. The location of the fenestration and aneurysms were noted. Results: CT angiographies of 887 patients (mean age 54.8 years, range 18-63 years; 405 women and 482 men) were evaluated. 164 fenestrastions found in 152 patients for a detection rate of 17.1%. Anterior communicating artery fenestrations were the most common (51.2%), followed by vertebrobasilar system fenestration (28.7%). In our study, no significant relationship was found between fenestration and aneurysm, regardless of localization (p>0.05). However, in the coexistence of fenestration and aneurysm, these are commonly located at the same localization (p: 0.005). Conclusion: Cerebral artery fenestration is an uncommon and mostly affects the anterior communicating artery and vertebrobasilar system. Cerebral artery fenestrations could be associated with aneurysms at the fenestration site. Further attention should be paid to the coexistence of aneurysm once intracranial artery fenestration has been found.

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Imaging detection of cerebral artery fenestrations and their clinical correlation with cerebrovascular diseases

Cited by 14 publications

References 24 publications

Acute pontine infarction in a patient with 8-shaped basilar artery fenestration malformation: A case report

Acute pontine infarction in a patient with 8-shaped basilar artery fenestration malformation: A case report

Hemodynamic effects of size and location of basilar artery fenestrations associated to pathological implications

Evaluation the Frequency of Cerebral Arterial Fenestrations and Their Association with Cerebral Aneurysm by CT Angiography

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