Anatomical Variations of Bilateral Posterior Circulation and Anterior Cerebral Artery: Case Report and Literature Review
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Abstract
It is not uncommon to find anatomical variations in the Circle of Willis in healthy individuals. These variations are typically singular or, more rarely, dual, and by definition, would not cause symptoms in the patient. However, reports in the literature suggest that these so-called "arterial variations" may be associated with the development of aneurysms, hemorrhages, and cerebral abnormalities, as well as increasing the risk of vascular insufficiency and severe brain damage during thromboembolic events. We present the case of a 64-year-old woman with complaints of refractory headache, whose magnetic resonance angiography demonstrated the association of three anatomical variations: azygos anterior cerebral artery, true fetal origin posterior cerebral artery, and complete fetal origin posterior cerebral artery.
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References
Freixinet JL, Caminero JA, Marchena J, Rodríguez PM, Casimiro JA, Hussein M. Spontaneous pneumothorax and tuberculosis: long-term follow-up. Eur Respir J. 2011;38(1):126-131. doi:10.1183/09031936.00128910. PMID: 20947681. Available from: https://pubmed.ncbi.nlm.nih.gov/20947681/
Ruiz CR, Nascimento SRR, Vidsiunas AK, Andrades L, Souza CC. Dupla variação anatômica vascular em um único indivíduo: estudo morfométrico. ABCS Health Sciences. 2017 Dec 11;42(3). doi: 10.7322/abcshs.v42i3.919.
Leite CC. Angiorressonância magnética intracraniana 3D “time-of-flight” (TOF). Radiologia Brasileira. 2024 Aug 01;37(3).
Valentim M. Angiografia por ressonância magnética: técnicas e práticas na rotina radiológica. Salutis Scientia. 2012 Jul 31;4.
Moore AFD. Anatomia Orientada Para a Clínica. 7th ed. Rio de Janeiro: Guanabara Koogan; 2014.
Vogl AW, Mitchel AWM, Drake RL. Gray's Anatomy for Students. 40th ed. Elsevier; 2009.
Paulsen F, Waschke J. Atlas de Anatomia Humana. 23rd ed. Rio de Janeiro: Gen Guanabara Koogan; 2012.
Louis ED, Mayer SA, Rowland LP. Merritt's Neurology. 12th ed. Rio de Janeiro: Guanabara Koogan; 2011.
Singh H, Dhandapani S, Mathuriya SN. Types of azygos distal anterior cerebral artery branching patterns: Relevance in aneurysmal surgery. Cureus. 2016 Jul 07. doi: 10.7759/cureus.681.
Makowicz G, Poniatowska R, Lusawa M. Variants of cerebral arteries - Anterior circulation. Pol J Radiol. 2013 Jul 07;78. doi: 10.12659/PJR.889403.
Tahir RA, Haider S, Kole M. Anterior cerebral artery: Variant anatomy and pathology. J Vasc Interv Neurol. 2019 May 05;10.
Baldawa S, Katikar D, Marda S. Giant saccular distal azygos artery aneurysm: Report of a case and review of literature. Asian J Neurosurg. 2011 Apr 04;11. doi: 10.4103/1793-5482.175621.
Chowdhury D. Azygos anterior cerebral artery aneurysm with subarachnoid hemorrhage. Neuroimmunology and Neu-roinflammation. 2018;5(9):39.
Kesanakurthy MVSN, Ghanta Rk. Azygos anterior cerebral artery aneurysm with subarachnoid hemorrhage. Asian J Neu-rosurg. 2016 Jul 07;11.
Tatu L, Moulin T, Bogousslavsky J. Arterial territories of the human brain cerebral hemispheres. Neurol Neurosci Frontal. 2012 Feb 14. doi: 10.1159/000333602.
Baptista AG. Studies on the arteries of the brain: II. The anterior cerebral artery: Some anatomic features and their clinical implications. Neurology. 1963 Oct 01. doi: 10.1212/wnl.13.10.825.
Coulier B. Duplication of the posterior cerebral artery (PCA) or “True Fetal PCA”: An extremely rare variant. J Belg Soc Radiol. 2018 Jan 01;102.
Lambert SL, Williams FJ, Oganisyan ZZ. Fetal-type variants of the posterior cerebral artery and concurrent infarction in the major arterial territories of the cerebral hemisphere. J Investig Med High Impact Case Rep. 2016 Sep 13. doi: 10.1177/2324709616665409.
Raamt AFV, Mali WPTM. The fetal variant of the circle of Willis and its influence on the cerebral collateral circulation. Ce-rebrovasc Dis. 2006 Jun 20. doi: 10.1159/000094007.
Masoud H, Nguyen TN, Thatcher J. Duplication of the posterior cerebral artery and the "true fetal" variant. Interv Neurol. 2015 Oct 01. doi: 10.1159/000437310.
Bulsara KR, Zomorodi A, Provenzale JM. Anatomic variant of the posterior cerebral artery. AJR Am J Roentgenol. 2007 Apr 01. doi: 10.2214/AJR.06.0991.
Netter FH. Atlas of human anatomy. 6th ed. Elsevier Health Sciences; 2014.