Carotid–anterior cerebral artery anastomosis

MR angiographic features and literature review


      Carotid–anterior cerebral artery anastomosis is a rare anomaly of the anterior part of the circle of Willis. We report here magnetic resonance (MR) angiographic findings in 2 patients with this anomaly. MR angiographic source images are useful in evaluating the anatomical details of this anomaly. Including the 2 present cases, 27 patients with this anomaly have been reported in the English-language literature. Thirty anomalous arteries were found in the 27 patients (R/L/bilateral=22/2/3). The reason for the right-sided predominance is unknown.


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        • Robinson LR
        An unusual human anterior cerebral artery.
        J Anat. 1959; 93: 131-133
        • Turnbull I
        Agenesis of the internal carotid artery.
        Neurology. 1962; 12: 588-590
        • McCormick WF
        A unique anomaly of the intracranial arteries of man.
        Neurology. 1969; 19: 77-80
        • Isherwood I
        • Dutton J
        Unusual anomaly of anterior cerebral artery.
        Acta Radiol Diagn (Stockh). 1969; 9: 345-351
        • Handa J
        • Matsuda M
        • Koyama T
        • Handa H
        • Kikuchi H
        • Hayashi K
        Internal carotid aneurysm associated with multiple anomalies of cerebral arteries.
        Neuroradiology. 1971; 2: 230-233
        • Teal JS
        • Rumbaugh CL
        • Segall HD
        • Bergeron RT
        Anomalous branches of the internal carotid artery.
        Radiology. 1973; 106: 567-573
        • Nutik S
        • Dilenge D
        Carotid–anterior cerebral artery anastomosis.
        J Neurosurg. 1976; 44: 378-382
        • Brismar J
        • Ackerman R
        • Roberson G
        Anomaly of anterior cerebral artery. A case report and embryologic considerations.
        Acta Radiol Diagn (Stockh). 1977; 18: 154-160
        • Bosma NJ
        Infra-optic course of anterior cerebral artery and low bifurcation of the internal carotid artery.
        Acta Neurochir (Wien). 1977; 38: 305-312
        • Kessler LA
        Unusual anomaly of the anterior cerebral artery.
        Arch Neurol. 1979; 36: 509-510
        • Milenkovic Z
        Anastomosis between internal carotid artery and anterior cerebral artery with other anomalies of the circle of Willis in a fetal brain.
        J Neurosurg. 1981; 55: 701-703
        • Bernini FP
        • Cioffi FA
        • Muras I
        • Rinaldi F
        Carotid siphon–pericallosal arterial anastomosis. Case report.
        Acta Neurochir (Wien). 1982; 66: 61-69
        • Senter HJ
        • Miller DJ
        Interoptic course of the anterior cerebral artery associated with anterior cerebral artery aneurysm.
        J Neurosurg. 1982; 56: 302-304
        • Sheehy JP
        • Kendall BE
        • Thomas DGT
        Infraoptic course of the anterior cerebral artery associated with a pituitary tumor.
        Surg Neurol. 1983; 20: 97-99
        • Fujimoto S
        • Murakami M
        Anomalous branch of the internal carotid artery supplying circulation of the anterior cerebral artery.
        J Neurosurg. 1983; 58: 941-946
        • Rosenorn J
        • Ahlgren P
        • Ronde F
        Pre-optic origin of the anterior cerebral artery.
        Neuroradiology. 1985; 27: 275-277
        • Klein SI
        • Gahbauer H
        • Goodrich I
        Bilateral anomalous anterior cerebral artery and infraoptic aneurysm.
        AJNR. 1987; 8: 1142-1143
        • Bollar A
        • Martinez R
        • Gelabert M
        • Garcia A
        Anomalous origin of the anterior cerebral artery associated with aneurysm-embryological considerations.
        Neuroradiology. 1988; 30: 86
        • Odake G
        Carotid–anterior cerebral artery anastomosis with aneurysm: case report and review of the literature.
        Neurosurgery. 1988; 23: 654-658
        • Mercier P
        • Velut S
        • Fournier D
        • Lescalie F
        • Guy G
        • Pillet J
        • Cronier P
        A rare embryologic variation: carotid–anterior cerebral artery anastomosis or infraoptic course of the anterior cerebral artery.
        Surg Radiol Anat. 1989; 11: 73-77
        • Onishi H
        • Yamashita J
        • Enkaku F
        • Fujisawa H
        Anomalous origin of the anterior cerebral artery and congenital skull dysplasia—case report.
        Neurol Med Chir (Tokyo). 1992; 32: 296-299
        • Sakai K
        • Asari S
        • Fujisawa M
        • Katagi R
        Ruptured aneurysm arising from the anomalous anterior cerebral artery—case report.
        Neurol Med Chir (Tokyo). 1992; 32: 846-850
        • Fujimura M
        • Seki H
        • Sugawara T
        • Tomichi N
        • Oku T
        • Higuchi H
        Anomalous internal carotid artery–anterior cerebral artery anastomosis associated with fenestration and cerebral aneurysm.
        Neurol Med Chir (Tokyo). 1996; 36: 229-233