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Kościołek D, Kobierecki M, Tokarski M, Szalbot K, Kościołek A, Malicki M, Wanibuchi S, Wiśniewski K, Piotrowski M, Bobeff EJ, Szmyd BM, Jaskólski DJ. The Anterior Inferior Cerebral Artery Variability in the Context of Neurovascular Compression Syndromes: A Narrative Review. Biomedicines 2024; 12:452. [PMID: 38398054 PMCID: PMC10887044 DOI: 10.3390/biomedicines12020452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024] Open
Abstract
The anterior inferior cerebellar artery (AICA) is situated within the posterior cranial fossa and typically arises from the basilar artery, usually at the pontomedullary junction. AICA is implicated in various clinical conditions, encompassing the development of aneurysms, thrombus formation, and the manifestation of lateral pontine syndrome. Furthermore, owing to its close proximity to cranial nerves within the middle cerebellopontine angle, AICA's pulsatile compression at the root entry/exit zone of cranial nerves may give rise to specific neurovascular compression syndromes (NVCs), including hemifacial spasm (HFS) and geniculate neuralgia concurrent with HFS. In this narrative review, we undertake an examination of the influence of anatomical variations in AICA on the occurrence of NVCs. Significant methodological disparities between cadaveric and radiological studies (CTA, MRA, and DSA) were found, particularly in diagnosing AICA's absence, which was more common in radiological studies (up to 36.1%) compared to cadaver studies (less than 5%). Other observed variations included atypical origins from the vertebral artery and basilar-vertebral junction, as well as the AICA-and-PICA common trunk. Single cases of arterial triplication or fenestration have also been documented. Specifically, in relation to HFS, AICA variants that compress the facial nerve at its root entry/exit zone include parabola-shaped loops, dominant segments proximal to the REZ, and anchor-shaped bifurcations impacting the nerve's cisternal portion.
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Affiliation(s)
- Dawid Kościołek
- Medical Faculty, Medical University of Lodz, Kosciuszki St., 90-419 Lodz, Poland; (D.K.); (M.K.); (M.T.); (K.S.); (A.K.); (M.M.)
| | - Mateusz Kobierecki
- Medical Faculty, Medical University of Lodz, Kosciuszki St., 90-419 Lodz, Poland; (D.K.); (M.K.); (M.T.); (K.S.); (A.K.); (M.M.)
| | - Mikołaj Tokarski
- Medical Faculty, Medical University of Lodz, Kosciuszki St., 90-419 Lodz, Poland; (D.K.); (M.K.); (M.T.); (K.S.); (A.K.); (M.M.)
| | - Konrad Szalbot
- Medical Faculty, Medical University of Lodz, Kosciuszki St., 90-419 Lodz, Poland; (D.K.); (M.K.); (M.T.); (K.S.); (A.K.); (M.M.)
| | - Aleksandra Kościołek
- Medical Faculty, Medical University of Lodz, Kosciuszki St., 90-419 Lodz, Poland; (D.K.); (M.K.); (M.T.); (K.S.); (A.K.); (M.M.)
| | - Mikołaj Malicki
- Medical Faculty, Medical University of Lodz, Kosciuszki St., 90-419 Lodz, Poland; (D.K.); (M.K.); (M.T.); (K.S.); (A.K.); (M.M.)
| | - Sora Wanibuchi
- The Faculty of Medicine, Aichi Medical University, Nagakute 480-1195, Japan;
| | - Karol Wiśniewski
- Department of Neurosurgery and Neuro-Oncology, Medical University of Lodz, Barlicki University Hospital, Kopcinskiego St. 22, 90-153 Lodz, Poland; (M.P.); (E.J.B.); (D.J.J.)
| | - Michał Piotrowski
- Department of Neurosurgery and Neuro-Oncology, Medical University of Lodz, Barlicki University Hospital, Kopcinskiego St. 22, 90-153 Lodz, Poland; (M.P.); (E.J.B.); (D.J.J.)
| | - Ernest J. Bobeff
- Department of Neurosurgery and Neuro-Oncology, Medical University of Lodz, Barlicki University Hospital, Kopcinskiego St. 22, 90-153 Lodz, Poland; (M.P.); (E.J.B.); (D.J.J.)
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Mazowieka St. 6/8, 92-251 Lodz, Poland
| | - Bartosz M. Szmyd
- Department of Neurosurgery and Neuro-Oncology, Medical University of Lodz, Barlicki University Hospital, Kopcinskiego St. 22, 90-153 Lodz, Poland; (M.P.); (E.J.B.); (D.J.J.)
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Sporna St. 36/50, 91-738 Lodz, Poland
| | - Dariusz J. Jaskólski
- Department of Neurosurgery and Neuro-Oncology, Medical University of Lodz, Barlicki University Hospital, Kopcinskiego St. 22, 90-153 Lodz, Poland; (M.P.); (E.J.B.); (D.J.J.)
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Ortega A, Damodaran O, Tan IYL, Silsby M. Bilateral trigeminal neuralgia due to bilaterally duplicated superior cerebellar arteries. BMJ Case Rep 2024; 17:e258818. [PMID: 38238165 PMCID: PMC10806915 DOI: 10.1136/bcr-2023-258818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024] Open
Affiliation(s)
- Alexandra Ortega
- Westmead Clinical School, The University of Sydney Faculty of Medicine and Health, Camperdown, New South Wales, Australia
| | - Omprakash Damodaran
- Neurosurgery Department, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Irene Yew Lan Tan
- Radiology Department, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Matthew Silsby
- Westmead Clinical School, The University of Sydney Faculty of Medicine and Health, Camperdown, New South Wales, Australia
- Neurology Department, Westmead Hospital, Westmead, New South Wales, Australia
- Neurology Department, Concord Repatriation General Hospital, Concord, New South Wales, Australia
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Davidoiu AM, Lazăr M, Vrapciu AD, Rădoi PM, Toader C, Rusu MC. An Update on the Superior Cerebellar Artery Origin Type. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2164. [PMID: 38138267 PMCID: PMC10744351 DOI: 10.3390/medicina59122164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/09/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: The microanatomy of the superior cerebellar artery (SCA) is clinically significant. We, thus, aimed at patterning unilateral and bilateral possibilities of SCA origin. Materials and Methods: In total, 205 archived records of computed tomography and magnetic resonance angiograms were used. There were defined types of SCA origin from the basilar artery (BA): "0"-absent SCA, "1"-preterminal, "2"-collateral SCA, with SCA appearing as a terminal branch of BA, and "3"-SCA from the posterior cerebral artery (PCA) of the cerebral type. Fenestrations and duplications of SCA were recorded. Bilateral combinations of types were recorded as follows: A (1 + 0), B (1 + 1), C (1 + 2), D (1 + 3), E (1 + duplicated SCA), F (2 + 2), G (2 + 3), H (3 + 3), I (3 + duplicated SCA), J (1 + fenestrated SCA). Results: Type 0 SCAs were found in 0.25%, type 1 in 71.29%, type 2 in 19.06%, and type 3 in 9.41%. Absent and fenestrated SCAs were each found in a single case. The most frequent combinations were B (58.05%), C (13.17%) and F (13.17%). Bilateral symmetrical types occurred in 70.7% of cases. Fetal types of PCA and the artery of Percheron modified the BA ends. Combinations of C, F, and G changed the BA ends or tips; thus, different subtypes resulted in five BA bifurcation patterns, including five BA trifurcations and one BA quadrifurcation. BA trifurcation was also found in cases with duplicated SCAs. Conclusions: The SCA has various anatomical possibilities of origin and bilateral combinations that are not presented in anatomical lectures. Details on the specific end of the BA should be gathered on a case-by-case basis.
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Affiliation(s)
- Ana-Maria Davidoiu
- Doctoral School, Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy, RO-300041 Timișoara, Romania;
| | - Mihai Lazăr
- Department 2, Division of Physiopathology II, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, RO-020021 Bucharest, Romania;
| | - Alexandra Diana Vrapciu
- Department 1, Division of Anatomy, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, RO-020021 Bucharest, Romania
| | - Petrinel Mugurel Rădoi
- Department 6–Clinical Neurosciences, Division of Neurosurgery, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, RO-020021 Bucharest, Romania; (P.M.R.); (C.T.)
- Clinic of Neurosurgery, “Dr. Bagdasar-Arseni” Emergency Clinical Hospital, RO-041915 Bucharest, Romania
| | - Corneliu Toader
- Department 6–Clinical Neurosciences, Division of Neurosurgery, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, RO-020021 Bucharest, Romania; (P.M.R.); (C.T.)
- Clinic of Neurosurgery, “Dr. Bagdasar-Arseni” Emergency Clinical Hospital, RO-041915 Bucharest, Romania
| | - Mugurel Constantin Rusu
- Department 1, Division of Anatomy, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, RO-020021 Bucharest, Romania
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Silva J, Viguini Tolentino Correa A, Alves da Silva I, Silva Pinto de Carvalho C, Ramina R. Trigeminal Neuralgia Due to Unilateral Early Bifurcated Superior Cerebellar Artery: Case Report and Literature Review. Cureus 2023; 15:e46201. [PMID: 37905292 PMCID: PMC10613432 DOI: 10.7759/cureus.46201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2023] [Indexed: 11/02/2023] Open
Abstract
Trigeminal neuralgia (TN) is considered a debilitating pain syndrome resulting from a neurovascular conflict in the prepontine cistern, usually through compression of the trigeminal nerve by the superior cerebellar artery (SCA), resulting in neural pathology at the root entry zone. This is a case report of a patient whose TN symptoms were attributed to an anatomical variant of the SCA, managed successfully through conservative treatment. Anatomical variants of the SCA have been related to TN. However, this is the first reported case in the PubMed literature of primary TN due to an unilateral early bifurcated SCA treated conservatively with first-line sodium channel blockers with a good outcome.
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Affiliation(s)
- Joseph Silva
- Neurosurgery, Instituto de Neurologia de Curitiba, Curitiba, BRA
| | | | | | | | - Ricardo Ramina
- Neurosurgery, Instituto de Neurologia de Curitiba, Curitiba, BRA
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