The Falcate Artery: Its Dynamics in Vasospasm.

Area of Science:

• Neurology
• Radiology
• Vascular Surgery

Background:

• Moyamoya disease shows enlarged anterior falcine arteries (AFA) contributing to collateral circulation.
• The AFA's role in perfusing ischemic brain tissue during vasospasm following subarachnoid hemorrhage (SAH-V) is investigated.

Purpose of the Study:

• To examine the angiographic characteristics of the AFA in SAH-V patients.
• To assess the reactive changes in AFA dimensions following nimodipine infusion chemical angioplasty (NCA).

Main Methods:

• Retrospective analysis of clinical and imaging data from 100 SAH patients with angiographic vasospasm.
• Digital subtraction angiography (DSA) used to evaluate AFA visibility and length.
• Mixed effect analysis applied for comparisons.

Main Results:

• The AFA was visualized in 59% of SAH-V patients, being longer in those with anterior communicating artery aneurysms and higher modified Fisher Scale (mFS) grades.
• Post-NCA, AFA length significantly reduced (p < 0.001), with greater reduction in severe vasospasm.
• Each centimeter increase in AFA length correlated with an 18.9% increase in vasospasm odds.

Conclusions:

• The AFA is a demonstrable angiographic feature in over 58% of SAH-V cases.
• AFA dimensions are significantly reduced after NCA, particularly in severe vasospasm.
• The AFA's size is a relevant indicator of vasospasm severity in SAH.