Interventions and imaging in patients with anatomic variations of cerebral circulation: a pictorial review

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• The cerebral arterial system exhibits significant anatomical variations in nearly all individuals.
• These variations, ranging from minor differences to major anomalies, are critical for understanding intracranial circulation.

Purpose of the Study:

• To review the imaging features of cerebral arterial system variants.
• To highlight the clinical significance of recognizing these variants in neurovascular assessment and surgical planning.

Main Methods:

• Review of imaging findings from computed tomography (CT), magnetic resonance imaging (MRI), and digital subtraction angiography (DSA).
• Inclusion of case illustrations demonstrating the impact of variant recognition on patient management.

Main Results:

• Anatomical variants in the cerebral arteries are frequent and diverse.
• Recognition is essential for evaluating collateral circulation, avoiding misdiagnosis of pathology, and assessing risks like aneurysm formation.
• Specific variants, such as fenestrations and persistent trigeminal arteries, are associated with increased risks.

Conclusions:

• Accurate identification of cerebral arterial variants through advanced imaging is vital for safe and effective neurovascular care.
• Understanding these variations improves preoperative planning and the management of associated pathologies.
• Knowledge of variants aids in interpreting imaging findings and optimizing patient treatment strategies.