Cerebral Aneurysms: Are They Associated with Anatomic Variations of Carotid and Main Cerebral Arteries?
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Published on: May 17, 2024
Jakub Polak1, Szymon Ciuk2, Iwona Kucybała1
1Department of Radiology, Jagiellonian University Medical College, Kraków, Poland.
Insights
Vascular anatomic variants like carotid artery origin variations, hypoplasia, or duplication of cerebral arteries are linked to a higher incidence of cerebral aneurysms. Carotid artery kinking, however, showed no correlation with aneurysm formation.
Area of Science:
- Vascular anatomy
- Neurology
- Radiology
Background:
- Vascular anatomic variations are common.
- The link between these variations and life-threatening vascular malformations, such as cerebral aneurysms, is not fully understood.
- Understanding this correlation is crucial for risk assessment and clinical management.
Purpose of the Study:
- To investigate the correlation between anatomical variants of carotid and major cerebral arteries and the presence of cerebral aneurysms.
- To assess specific variants including common carotid artery origin, cerebral artery hypoplasia/duplication, and carotid artery kinking.
Main Methods:
- Analysis of computed tomography angiography (CTA) scans of 194 patients.
- Evaluation of common carotid artery origin variations (e.g., bovine arch), cerebral artery hypoplasia or duplication, and internal carotid artery kinking.
- Statistical analysis to determine the association between these variants and cerebral aneurysms.
Main Results:
- Cerebral aneurysms were present in 5.7% of patients.
- Hypoplasia (34.5%) and duplication (2.6%) of major cerebral arteries were significantly associated with cerebral aneurysms (OR=3.175 and OR=18.500, respectively).
- Alternative aortic arch branching patterns increased the likelihood of cerebral aneurysms (OR=5.903), while carotid artery kinking did not show a significant association (P=0.378).
Conclusions:
- A clear association exists between specific vascular anatomical variants and the occurrence of cerebral aneurysms.
- Variants in carotid artery origin and cerebral artery development (hypoplasia, duplication) are important risk factors.
- Carotid artery kinking is not a predisposing factor for cerebral aneurysm formation.
Objective:
Vascular anatomic variations are very common in the population, but their coexistence with life-threating vascular malformations remains unclear. The objective of the study was to assess the correlation between the presence of anatomic variants of both carotid and main cerebral arteries and the occurrence of cerebral aneurysms.
Methods:
We analyzed examinations of 194 patients who underwent computed tomography angiography of the head and neck between September of 2016 and November of 2017. The assessed parameters were: the variation of the common carotid arteries origin, hypoplasia or duplication of any of the main cerebral arteries, carotid artery kinking, and the presence of cerebral aneurysms.
Results:
We found 5.7% of patients had a cerebral aneurysm. Hypoplasia of at least 1 main cerebral artery occurred in 34.5% of patients, with the most frequent being the vertebral artery (21.6%). Duplication of at least 1 main cerebral artery was detected in 2.6%. Cerebral aneurysms occurred more often together with hypoplasia (P = 0.041; OR = 3.175) or duplication (P < 0.001; OR = 18.500) of at least 1 main cerebral artery. In 7.2% of cases, the origin of common carotid arteries created a true bovine arch, and in 4.1% the so-called bovine arch. Patients with alternative variants of aortic arch branching were more likely to have cerebral aneurysms (P = 0.002; OR = 5.903). We found 27.3% of patients had internal carotid arteries affected by kinking. Carotid kinking did not predispose the patient to the formation of a cerebral aneurysm (P = 0.378).
Conclusions:
There is an evident correspondence between the presence of vascular anatomic variants (abnormal origin of the carotid arteries, hypoplasia, or duplication of the main cerebral artery) and the occurrence of cerebral aneurysms.
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