Abstract
ObjectivesThe aim of this retrospective study was twofold: (1) to show the role of multi-detector computed tomography angiography (MDCTA) in the evaluation of intracranial arterial anatomic variations; (2) to highlight their clinical importance with illustrated example cases.Materials and methodsOne thousand seven hundred thirty-nine patients who underwent carotid and/or cerebral CTA using a 16-row multi-detector CT over the last 9 years were retrospectively analysed with attention to the presence of persistent carotid-basilar anastomosis and other intracranial arterial variations.ResultsAll kinds of persistent carotid-basilar anastomosis were present in our series. The most common was the presence of fetal pCom (23 %). From the other studied anatomic variants, the most common was the presence of a hypoplastic A1 segment. In all cases CTA was an excellent diagnostic tool, providing not only high-resolution angiographic images, but also details of the surrounding structures.ConclusionsThe knowledge of intracranial anatomic variations could be very important for the treatment planning of patients who need neurointervention or to explain uncommon and unexpected clinical findings. CTA can reliably provide this kind of information by depicting intracranial anatomic variations.Teaching Points• Knowledge of intracranial anatomic variations is important. • Radiologist should be aware of the intracranial anatomic variations. • Computed tomography angiography can reliably depict intracranial anatomic variations.
Highlights
The existence of persistent embryonic communications between the carotid and vertebro-basilar arterial systems and other anatomic variations is well recognised
We pictorially reviewed the anatomic configuration of the carotid-vertebrobasilar anastomoses, and some other rare anatomic variations as they appear in the computed tomography angiography (CTA) and illustrate their importance in clinical practice
The most common persistent carotid-basilar anastomosis was the presence of a foetal type of posterior communicating artery
Summary
The existence of persistent embryonic communications between the carotid and vertebro-basilar arterial systems and other anatomic variations is well recognised. As endovascular procedures become even more common, the need for detailed understanding of such anatomy, together with the variations that may be encountered becomes more pressing. These anatomical variations reflect the embryological development of the organism and the phylogeny of the species. CTA provides high-resolution angiographic images and excellent details of the surrounding structures as well [2]. This can be very important for the recognition of certain anatomic variations.
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