PubMed · 12234448
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Albert L Rhoton. 2002. Aneurysms.. https://pubmed.ncbi.nlm.nih.gov/12234448/
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We reviewed the selective endosaccular coiling of eight consecutive patients with saccular basilar trunk aneurysms, seven after subarachnoid haemorrhage (SAH). All aneurysms could be coiled in a mean procedure time of 61 min. There were no procedure-related complications, but one patient died of vasospasm following the SAH. The remaining seven had a good outcome, and five of seven aneurysms were completely occluded with a stable result on follow-up angiography. Compaction of the coils occurred in one very large aneurysm necessitating additional coiling. One patient with a giant, partially thrombosed aneurysm was coiled four times in a 3-year period to obtain a satisfactory anatomical result.
In the embryonic period, several developmental anomalies of the cerebral arteries occur. The knowledge of these anatomic variations of the cerebral artery is important to avoid the unnecessary surgery and to undergo surgery or interventional radiology with safety. We reviewed 3000 MR angiographies and 700 cerebral angiographies of the previous 5 years to assess cerebral arterial system, and to illustrate the embryological development, imaging findings, occurrence, and clinical significance of the anatomic variation of the cerebral arteries. The normal development and variations of the cerebral arteries are depicted. Knowledge of the anatomic variations is important since it can influence surgical and interventional procedure.
Congenital absence of the unilateral internal carotid artery (ICA) was found in a patient during MR imaging examination for right trigeminal neuralgia. Magnetic resonance angiography showed complete absence of the right ICA and a large tortuous basilar artery (BA). The source images revealed a deformed right trigeminal nerve resulting from compression by the BA. Computed tomography of the skull base showed absence of the right carotid canal, suggesting agenesis of the right ICA. Longstanding hemodynamic stress may have caused the BA to become extremely tortuous, resulting in the trigeminal neuralgia.