Incidental Discovery of an Azygos-type Anterior Cerebral Artery in a Cluster Headache Patient: A Case Report

Abstract

IntroductionIntracranial arterial variations are prevalent and do not necessarily compromise cerebral blood flow. These variations, including the persistence of embryonic features like the fetal posterior cerebral artery pattern from the internal carotid artery, are commonly found during neuroradiological evaluation and noted in neurological assessments for symptoms like headaches and dizziness. Primary headaches such as cluster headaches require differential diagnosis to exclude organic causes like parasellar lesions, which mimic their presentation. In this article, we aim to report a case of an adult patient who experienced a typical episode of cluster headache, and during the radiological investigation, we identified the presence of an azygos-type anterior cerebral artery (possibly unrelated to the trigeminal autonomic cephalalgia).Case reportThis article presents a case of a 73-year-old male experiencing severe, right-sided orbital-fronto-parietal headaches at age 45, diagnosed as cluster headaches. Accompanied by tearing and redness of the right eye, episodes lasted 30-60 minutes, and agitation. Despite the pain's intensity, oxygen therapy provided relief. Recent MRI scans, prompted by two months of dizziness, revealed an azygos anterior cerebral artery without other abnormalities, highlighting a rare anatomical variant.ConclusionIn conclusion, we have presented a case involving a patient with a history of cluster headaches who, upon undergoing MRI evaluation, was discovered to have an azygos-type anterior cerebral artery. Considering the uncommon nature of this anatomical variation, we believe it is crucial to report and document this finding.