Terminal end Variations and Common Pathological Abnormalities of the Basilar Artery among the Ugandan Population: a Human Autopsy Study

Abstract

Introduction Morphological variations at the basilar artery terminal end are documented risk factors for cerebral vascular complications like atherosclerosis, thromboembolisms, and aneurysms that further predispose to fatal arterial occlusions. Pathological abnormalities of the basilar artery are usually ignored on diagnosis in third world countries despite their role in brain ischemia. There is a paucity of literature on the gross anatomy of cerebral vasculature in the Ugandan population. Therefore, this study set out to determine the terminal end variations and common pathological abnormalities of the basilar artery among the Ugandan population. Materials and Methods This was a cross sectional study that accessed intact basilar arteries from 115 human autopsy brains (77 males and 33 females) at the Kampala City Council Authority mortuary. Arachnoid matter was removed and arteries perfused with clear water for visibility. The arteries were checked for variations including bifurcations, trifurcations, quadrifurcation, hexafuraction and pathological abnormalities. Representative photographs were taken and results presented as proportions and percentages. Results The average age of the human cadavers was 38 years (Range 18-85 years). Normal bifurcation of the basilar artery was observed in 48.7% of the study population. Other variations included trifurcations (22.6%); quadrifurcations (21.7%), pentafurcations (6.1%) and hexafurcations (0.6%). With regard to abnormalities, 16 arteries (13.9%) had atheromatous plaques, 21 (18.3%) were rigid, and 26 (22.6%) were tortuous. There was significant correlation between age and pathological abnormalities (p ¼ 0.01) Conclusion There are several variations at the terminal end of the basilar artery in the Ugandan population. Arterial pathological abnormalities are also not uncommon and tend to increase with age. Thus, the need for routine imaging investigations in patients with cerebrovascular disorders and individuals of 40 years and above.

Anatomical variations of the superior cerebellar artery: A cadaveric study at the University Teaching Hospitals, Lusaka, Zambia

“…In the present study, triplication was observed in 4.9% of the cases, all were right unilateral SCAs arising from the BA. This finding is slightly lower than the reported cases of 6.1% by Nagawa et al (2018) in a Ugandan black population. On the other hand, the present study finding is almost comparable with the study done by Gunnal et al (2014) who reported triplication at the rate of 5.29%.…”

“…Nagawa et al (2018), who reported the origin of the SCA as a single vessel in 51.3% in a black Ugandan population. However, these results were contrary to the findings of Ogeng'o et al(2015) who reported a higher rate of single origin of the SCA from the BA with a frequency of 72.1% in a black Kenyan population.In the current study, the SCA took origin from the PCA in 5.7% of the cases.…”

An Update on the Superior Cerebellar Artery Origin Type

“…Morphological patterns of the basilar artery furcation are consistent with other studies[23,24] and the present study. BA: basilar artery; PComA: posterior communicating artery; PCA: posterior cerebral artery; fPCA: fetal type of posterior cerebral artery; SCA: superior cerebellar artery; aP: artery of Percheron.…”

“…Gunnal et al described the pentafurcations of the BA by including double SCAs in the counts and without distinguishing the origins of SCAs as collateral/terminal/cerebral types [23]. Similarly, Nagawa et al (2018) found penta-and hexafurcations of BA determined by double or triple SCAs, but they did not discriminate SCAs' exact sites of origin [24]. et al described the situations with an absent P1 segment as non-furcation, making the SCA appear on that side of terminal type 2, with the contralateral P1 segment inserted medially at the apex of AB [23]; this morphology corresponds to the C (1 + 2) and G (2 + 3) types of bilateral combinations in the present study and should be correlated to certain furcations of the BA.…”