Learning objectives
1. To present types of fetal persistent primitive carotid-vertebrobasilar anastomoses.
2. To recognize these persistent arteries, be aware of their clinical significance and to report them before surgical and interventional procedures.
Background
In the early embryonic period between internal carotid artery(ICA) and longitudinal neural artery four transient anastomoses rarely persist in adulthood:
1-Persistent trigeminal artery (PTA)
2-Persistent otic artery (POA)
3-Persistent hypoglossal artery (PHA)
4- Persistent primitive proatlantal intersegmental arteries (PPPIA) [1] (Figure 1).
The prevalence of carotid-vertebrobasilar anastomoses is reported approximately as 0.1-1% [2].
We will review the characteristic features of persistent fetal carotid-vertebrobasilar anastomoses with different radiological imaging techniques.
Findings and procedure details
EMBRYOLOGY
These primitive embryonic anastomoses exist during very early period of cerebral arterial development and rapidly involute within a week however may persist after birth and discovered in adult life [1].
During the 4-mm embryo stage, the forebrain is supplied by the carotid system and a couple of longitudinal neural arteries. Between them, there are three presegmental arterial anastomoses named according to the corresponding cranial nerves; the trigeminal artery, the otic artery, the hypoglossal artery, and the fourth one proatlantal intersegmental artery.
During the 5-...
Conclusion
The persistent primitive carotid-vertebrobasilar anastomoses are although rare they are worth recognizing.
Personal information and conflict of interest
H. Erk; Istanbul/TR - nothing to disclose K. Harmanci; Istanbul/TR - nothing to disclose
References
1-NAMBA, Katsunari. (2017). Carotid-vertebrobasilar Anastomoses with Reference to Their Segmental Property. Neurologia medico-chirurgica. 57. 10.2176/nmc.ra.2017-0050.
2-Dimmick, Simon & Faulder, Kenneth. (2009). Normal Variants of the Cerebral Circulation at Multidetector CT Angiography. Radiographics : a review publication of the Radiological Society of North America, Inc. 29. 1027-43. 10.1148/rg.294085730.
3-Padget, Dh. (1947). The Development of the Cranial Arteries in the Human Embryo. Contrib Embryol. 32.
4-Yilmaz E, Erhan I, Dogan T. Primitive persistent carotid-basilar and carotid-vertebral anasto- moses: a reportof seven cases and a review of theliterature.Clin...
