True terminal pentafurcation of the external carotid artery and terminal trifurcation of the contralateral one, occipitoauricular trunk, retropharyngeal internal carotid artery

Moraru, Liliana; Rusu, Mugurel Constantin; Popescu, Şerban Arghir

doi:10.1007/s00276-021-02812-8

Cited by 7 publications

(7 citation statements)

References 11 publications

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“…We consider that for surgeons a bone landmark is more important in identifying an artery than identifying and counting the sequence of ECA branches. Moreover, rare anatomical variants, such as the pentafurcation of the ECA [ 6 ], could not respect a certain order of the arterial origins.…”

Section: Discussionmentioning

confidence: 99%

“…The CTAs were performed with a 32-slice scanner (Siemens Multislice Perspective Scanner), with a 0.6 mm collimation and a reconstruction of 0.75 mm thickness with 50% overlap for a multiplanar maximum intensity projection and three-dimensional volume rendering technique, as described previously [ 6 , 7 ]. The cases were documented using Horos for iOS (Horos Project) [ 8 ].…”

Section: Methodsmentioning

confidence: 99%

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Vertical Levels of the Occipital Artery Origin

et al. 2023

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Background and Objectives. The occipital artery (OA) is a posterior branch of the external carotid artery (ECA). The origin of the OA is commonly referred to a single landmark. We hypothesized that the origin of the OA could be variable as referred to the hyoid bone and the gonial angle. We thus aimed at patterning the vertical topographic possibilities of the OA origin. Materials and Methods. One hundred archived computed tomography angiograms were randomly selected, inclusion and exclusion criteria were applied, and 90 files were kept (53 males, 37 females). The cases were documented bilaterally for different levels of origin of the OA origin: type 1—infrahyoid; type 2—hyoid; 3—infragonial; 4—gonial; 5—supragonial; 6—origin from the internal carotid artery (ICA). Results. The incidence of unilateral types in the 180 OAs was: type 1—1.11%, type 2—5.56%, type 3—40.56%, type 4—28.33%, type 5—23.33% and type 6, ICA origin of the OA—1.11%. There was found a significant association between the location of the left and right origins of the OAs (Pearson Chi2 = 59.18, p < 0.001), which suggests the presence of a strong symmetry of the origins. Bilateral symmetry of the vertical types of the OA origin was observed in 56.67% of cases; in 43.33% there was bilateral asymmetry. Conclusions. The ICA origin of the OA is an extremely rare variant. For surgical planning or prior to endovascular approaches the topography of the OA origin should be carefully documented, as it may be located from an infrahyoid to a supragonial level.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Vertical Levels of the Occipital Artery Origin

et al. 2023

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“…The CTAs were performed with a 32-slice scanner (Siemens Multislice Perspective Scanner, Erlangen, Germany), with a 0.6 mm collimation and a reconstruction of 0.75 mm thickness, with 50% overlap for a multiplanar maximum intensity projection and three-dimensional volume rendering technique, as described previously [ 9 ]. The cases were documented using Horos for iOS (Horos Project) [ 10 ].…”

Section: Methodsmentioning

confidence: 99%

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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“…CT scans were performed with a 32-slice scanner (Siemens Multislice Perspective Scanner), with a 0.6 mm collimation and a reconstruction of 0.75 mm thickness with 50% overlap for a multiplanar maximum intensity projection and three-dimensional volume rendering technique, as described previously [ 16 ]. The cases were documented using Horos for iOS (Horos Project).…”

Section: Methodsmentioning

confidence: 99%

Transcallosal and Pericallosal Courses of the Anterior Cerebral Artery

et al. 2022

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(1) Background: The anterior cerebral artery (ACA) has a precommunicating A1 segment, followed by a postcommunicating A2 segment. Anatomically, after it sends off from the callosomarginal artery (CMA), it continues as the pericallosal artery (PCalA). A detailed pattern of the anatomical variations of the PCalA are needed for practical reasons. (2) Methods: There were 45 retrospectively documented Computed Tomography Angiograms of 32 males and 13 females. (3) Results: In 90 sides, eleven different types of PCalA were documented: type 1: normal origin, above the genu of the corpus callosum (CC) (51.11%); type 2: low origin, below the rostrum of the CC (8.88%); type 3: late origin, above the body of the CC (3.33%); type 4, initial transcallosal course (3.33%); type 5, duplicated PCalA (1.11%); type 6, azygos PCalA (2.22%); type 7, absent PCalA (CMA type of ACA) (7.78%); type 8: CMA continued as PCalA (5.56%); type 9: PCalA continued as the cingular branch (1.11%); type 10: PCalA type of ACA, absent CMA (14.44%); type 11: triple PCalA, with an added median artery of the CC (1.11%). Different types of CMA were also documented: type 0, absent CMA (17.78%); type 1, CMA with frontoparietal distribution (45.56%); type 2, CMA with parietal distribution (22.22%); type 3, low origin of CMA, either from A1, or from A2 (8.88%); type 4, CMA continued as PCalA (5.56%). Ipsilateral combinations of PCalA and CMA types were classified as types A-P. In 33/45 cases (73.3%), the bilateral asymmetry of the combined anatomical patterns of PCalA and CMA was documented. Additional rare variations were found: (a) huge fenestration of A2; (b) bihemispheric ACAs (6/45 cases); (c) twisted arteries within the interhemispheric fissure. (4) Conclusions: The PCalA and CMA are anatomically diverse and unpredictable. Therefore, they should be documented on a case-by-case basis before surgical or endovascular approaches.

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True terminal pentafurcation of the external carotid artery and terminal trifurcation of the contralateral one, occipitoauricular trunk, retropharyngeal internal carotid artery

Cited by 7 publications

References 11 publications

Vertical Levels of the Occipital Artery Origin

Vertical Levels of the Occipital Artery Origin

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

Transcallosal and Pericallosal Courses of the Anterior Cerebral Artery

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