Multiple Rare Anatomic Variations in Anterior and Posterior Cerebral Circulation: A Case Report

Area of Science:

• Neurology
• Vascular Anatomy
• Medical Imaging

Background:

• Intracranial arterial variations are critical for neurosurgical and interventional radiology procedures.
• Accurate identification of these variations is essential for patient safety.

Observation:

• Magnetic resonance angiography (MRA) was used to examine the intracranial vascular anatomy of a 56-year-old female patient.
• Three exceptionally rare arterial variants were identified during the MRA review.

Findings:

• A persistent primitive lateral basilovertebral anastomosis connected the left anterior and posterior inferior cerebellar arteries, with the left anterior inferior cerebellar artery forming a loop.
• The right posterior inferior cerebellar artery exhibited distal fenestration in its telovelotonsillar segment.
• A partially duplicated anterior communicating artery was observed in the anterior circulation.

Implications:

• This case highlights the importance of MRA in detecting and characterizing rare intracranial arterial anomalies.
• Awareness of such variants is crucial for neurosurgeons and interventional radiologists to prevent complications.
• Detailed anatomical knowledge aids in planning and executing complex cerebrovascular interventions.