Persistent fetal intracranial arteries: a comprehensive review of anatomical and clinical significance

A review

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As fetal intracranial vessels may persist into adulthood, knowledge of their anatomy and potential clinical and surgical complications should be borne in mind by the surgeon. A comprehensive review of these vessels, however, is not easily identified in the literature. Therefore, the present analysis was undertaken so that such information is available to the clinician and morphologist.

Abbreviations used in this paper: BA = basilar artery; ECA = external carotid artery; ICA = internal carotid artery; PCA = posterior cerebral artery; PCoA = posterior communicating artery; PICA = posterior inferior cerebellar artery; SCA = superior cerebellar artery; VA = vertebral artery.

Article Information

Address correspondence to: R. Shane Tubbs, M.S., P.A.-C., Ph.D., Section of Pediatric Neurosurgery, Children's Hospital, 1600 7th Avenue South ACC 400, Birmingham, Alabama 35233. email: shane.tubbs@chsys.org.

Please include this information when citing this paper: published online January 14, 2011; DOI: 10.3171/2010.11.JNS101527.

© AANS, except where prohibited by US copyright law.

Headings

Figures

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    Schematic depictions of the persistent trigeminal (A), otic (B), hypoglossal (C), and proatlantal (D) arteries.

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    Artist's rendition of the 4 persistent fetal arteries and their relationships to the skull base.

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    Angiogram of a persistent trigeminal artery.

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    Cadaveric image following brain removal demonstrating a left-sided persistent trigeminal artery (PTA). Note the left abducent (VI) and trigeminal (V) nerves. IC = ICA.

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    Angiogram noting a persistent otic artery at (arrowhead).

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    Conventional angiogram. Left anterior oblique projection, left ICA injection. The hypoglossal artery (white arrow) arises from the left ICA (black arrow). The white arrowhead indicates site of hypoglossal canal, through which the hypoglossal artery passes, lying medial to the entry to the carotid canal (black arrowhead).

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    Three-dimensional MR angiogram with contrast of the cervical arteries. The hypoglossal artery (black arrows) arises from right ICA (white arrow). The right ECA is indicated by the arrowhead.

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    Three-dimensional contrast-enhanced reconstructed CT scan of the neck. The hypoglossal artery emerges from right hypoglossal canal (arrowhead).

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    Conventional angiogram. Lateral projection, left ICA injection. The arrow indicates proatlantal artery arising from the posterior aspect of the left ICA.

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