Persistent primitive olfactory artery without a hairpin turn
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ANATOMIC VARIATIONS
Persistent primitive olfactory artery without a hairpin turn Akira Uchino1 · Hitoshi Ohno1 · Tsuneaki Ogiichi2 Received: 27 June 2020 / Accepted: 6 October 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Persistent primitive olfactory artery (POA) is a relatively rare variation of the proximal anterior cerebral artery (ACA) that generally follows an extreme anteroinferior course and takes a hairpin turn before continuing to the A2 segment of the ACA. There are other extremely rare variations, such as (1) that continuing to the ethmoidal artery without a hairpin turn, (2) that continuing to both ethmoidal artery and distal ACA with a hairpin turn, and (3) that continuing to the accessory middle cerebral artery with a hairpin turn. We herein report a case of persistent POA without a hairpin turn continuing to the A3 segment of the ACA. We propose calling this new type of persistent POA Type 5. Keywords Anterior cerebral artery · Cerebral arterial variation · Magnetic resonance angiography · Primitive olfactory artery
Introduction
Case report
Rarely, the proximal segment of the anterior cerebral artery (ACA) courses extremely anteroinferiorly, makes a hairpin turn, and connects posterosuperiorly to the normal A2 segment. The primitive olfactory artery (POA) usually regresses during early gestation [8], but when it persists, this anomalous ACA is formed, called persistent POA [10]. There are other rare variations of the persistent POA, including that connecting to the ethmoidal artery [6] or to the accessory middle cerebral artery (MCA) [3, 4, 10]. We herein report a case of persistent POA without a hairpin turn. This artery ran superiorly and connects to the A3 segment of the ACA and was diagnosed using magnetic resonance (MR) angiography.
A 71-year-old man with cerebral infarctions underwent cranial MR imaging and MR angiography using a 1.5-T scanner (Magnetom essenza, Siemens Medical System, Erlangen, Germany). MR angiography was obtained using a standard three-dimensional time-of flight technique. The imaging parameters were a repetition time of 29.0 s, echo time of 7.15 s, and slice thickness of 0.8 mm. MR imaging revealed multiple small cerebral infarctions in the bilateral cerebral hemispheres (not shown). MR angiography showed neither occlusion nor significant stenosis of the cerebral arteries. However, an anomalous course of the A2 segment of the right ACA was found (Fig. 1). Normally, the A2 segment of ACA takes a cephalad course. The present case showed a right ACA with an anterior course along the midline anterior cranial fossa, followed by a cephalad course without a hairpin turn, connecting to the A3 segment. The findings were obvious on the source image (Fig. 2) and on the partial volume rendering image (Fig. 3).
* Akira Uchino [email protected] 1
Department of Radiology, Saitama Sekishinkai Hospital, 2‑37‑20 Irumagawa Sayama, Saitama 350‑1305, Japan
Department of Neurosurgery, Sayama General Clinic, 4‑15‑25 Irumagawa Sayama,, Saitama 35
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