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Differences between middle cerebral artery bifurcations with normal anatomy and those with aneurysms
Takashi Sadatomo1, Kiyoshi Yuki, Keisuke Migita
1Department of Neurosurgery, Higashihiroshima Medical Center, Jike 513, Saijyo, Higashihiroshima, Hiroshima, 739-0041, Japan. sadatomo@k2.dion.ne.jp
Neurosurgical Review
|January 29, 2013
Summary
Middle cerebral artery (MCA) bifurcations in patients with aneurysms show less symmetry in branch width and angles compared to normal anatomy. These anatomical differences in the daughter artery ratio and lateral angle ratio are significant in aneurysm patients.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Medical Imaging
Background:
- Middle cerebral artery (MCA) aneurysms are a significant cause of cerebrovascular disease.
- Understanding the anatomical variations in MCA bifurcations is crucial for aneurysm development and treatment.
Purpose of the Study:
- To define the normal anatomy of MCA bifurcations.
- To identify and analyze anatomical differences in MCA bifurcations between healthy individuals and patients with MCA aneurysms.
Main Methods:
- Three-dimensional magnetic resonance angiography (3D-MRA) was used to assess 62 healthy individuals.
- Three-dimensional digital subtraction angiography (3D-DSA) was used for 54 MCA aneurysm patients.
- Measurements included M1 and M2 branch widths, lateral angles, daughter artery ratio (DA ratio), and lateral angle ratio (LA ratio).
Main Results:
- Normal MCA bifurcations exhibit symmetrical M2 branches and lateral angles.
- MCA bifurcations in patients with aneurysms showed significantly wider lateral angles and a higher DA ratio compared to normal controls (p < 0.05).
- The LA ratio was significantly higher in aneurysmal MCAs (2.1 ± 1.4) versus normal MCAs (1.3 ± 0.4) (p < 0.01).
Conclusions:
- MCA bifurcations in patients with aneurysms deviate from the symmetrical structure observed in healthy individuals.
- These anatomical asymmetries, particularly in lateral angles and branch width ratios, may be associated with MCA aneurysm formation.
- The findings suggest potential morphological risk factors for MCA aneurysm development.
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