Infundibular widening mimicking anterior communicating artery aneurysm

Report of 2 cases

Jaechan Park M.D. and Dong-Hun Kang M.D.
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  • Department of Neurosurgery, Cardiocerebrovascular Center, Kyungpook National University, Daegu, Republic of Korea
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Because infundibular widening most commonly appears at the origins of the posterior communicating artery and anterior choroidal artery from the internal carotid artery, its occurrence in association with the anterior communicating artery (ACoA) or the A1-A2 junction can be misinterpreted as an ACoA aneurysm on angiograms.

The authors report on 2 such cases; one in a 73-year-old woman with infundibular widening of the recurrent artery of Heubner, and the other in a 44-year-old woman with infundibular widening of a perforating vessel from the ACoA. The correct diagnosis was established based on surgical exploration. In addition, grayscale modification of 3D reconstruction images of preoperative digital subtraction angiography revealed the cases of the recurrent artery of Heubner and perforating artery of the ACoA arising from the apex of the infundibular widening.

Abbreviations used in this paper:ACA = anterior cerebral artery; AChA = anterior choroidal artery; ACoA = anterior communicating artery; DSA = digital subtraction angiography; ICA = internal carotid artery; ICH = intracerebral hemorrhage; LSA = lenticulostriate artery; OphA = ophthalmic artery; PCA = posterior cerebral artery; PCoA = posterior communicating artery; SCA = superior cerebellar artery.

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Contributor Notes

Address correspondence to: Jaechan Park, M.D., Department of Neurosurgery, Kyungpook National University Hospital, 50, Samduk 2-ga, Jung-gu, Daegu, South Korea 700-721. email: jparkmd@hotmail.com.

Please include this information when citing this paper: published online April 19, 2013; DOI: 10.3171/2013.3.JNS122058.

  • 1

    Endo S, , Furuichi S, , Takaba M, , Hirashima Y, , Nishijima M, & Takaku A: Clinical study of enlarged infundibular dilation of the origin of the posterior communicating artery. J Neurosurg 83:421425, 1995

    • Search Google Scholar
    • Export Citation
  • 2

    Epstein F, , Ransohoff J, & Budzilovich GN: The clinical significance of junctional dilatation of the posterior communicating artery. J Neurosurg 33:529531, 1970

    • Search Google Scholar
    • Export Citation
  • 3

    Hernesniemi J, , Dashti R, , Lehecka M, , Niemelä M, , Rinne J, & Lehto H, : Microneurosurgical management of anterior communicating artery aneurysms. Surg Neurol 70:829, 2008

    • Search Google Scholar
    • Export Citation
  • 4

    Koike G, , Seguchi K, , Kyoshima K, & Kobayashi S: Subarachnoid hemorrhage due to rupture of infundibular dilation of a circumflex branch of the posterior cerebral artery: case report. Neurosurgery 34:10751077, 1994

    • Search Google Scholar
    • Export Citation
  • 5

    Kuwahara S, , Uga S, & Mori K: Successful treatment of a ruptured enlarged infundibular widening of the posterior communicating artery—case report. Neurol Med Chir (Tokyo) 41:2528, 2001

    • Search Google Scholar
    • Export Citation
  • 6

    Morris P: Practical Neuroangiography ed 2 Philadelphia, Lippincott Williams & Wilkins, 2007. 338339

  • 7

    Osborn AG: Diagnostic Cerebral Angiography ed 2 Philadelphia, Lippincott Williams & Wilkins, 1999. 272273

  • 8

    Papke K, , Kuhl CK, , Fruth M, , Haupt C, , Schlunz-Hendann M, & Sauner D, : Intracranial aneurysms: role of multidetector CT angiography in diagnosis and endovascular therapy planning. Radiology 244:532540, 2007

    • Search Google Scholar
    • Export Citation
  • 9

    Saltzman GF: Infundibular widening of the posterior communicating artery studied by carotid angiography. Acta Radiol 51:415421, 1959

  • 10

    Trasi S, , Vincent LM, & Zingesser LH: Development of aneurysm from infundibulum of posterior communicating artery with documentation of prior hemorrhage. AJNR Am J Neuroradiol 2:368370, 1981

    • Search Google Scholar
    • Export Citation
  • 11

    Wollschlaeger G, & Wollschlaeger PB, The circle of Willis. Newton TH, & Potts DG: Radiology of the Skull and Brain St. Louis, CV Mosby, 1974. 2:11711201

    • Search Google Scholar
    • Export Citation

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