PDF(Pubmed)
Abstract：
BACKGROUND: A bilateral infraoptic origin of the anterior cerebral arteries (ACAs) is a rare anatomical variant that can be encountered during anterior skull base surgery. The ACAs arise from the internal carotid artery (ICA) at the level of the ophthalmic artery and course medially, traveling inferior to the ipsilateral optic nerves. Herein, the authors discuss the different configurations of the anatomical variant, its prevalence, and hypotheses leading to the variable configuration of this anomaly.
METHODS: A 67-year-old woman presented with worsening dizziness over a week-long period and was found to have a large left sphenocavernous meningioma with optic, cavernous, and suprasellar extension. The tumor incorporated the left supraclinoid ICA and its branches. She underwent a left modified orbitozygomatic craniotomy for tumor resection. Early identification of the aberrant ACA anatomy was crucial in avoiding vascular injury.
CONCLUSIONS: While this variant is typically encountered during the treatment of vascular pathologies-namely, intracranial aneurysms-its existence should be kept in mind during the treatment of any anterior skull base pathology. Failure to account for the presence of this variant may lead to potential intraoperative complications.
METHODS: A 67-year-old woman presented with worsening dizziness over a week-long period and was found to have a large left sphenocavernous meningioma with optic, cavernous, and suprasellar extension. The tumor incorporated the left supraclinoid ICA and its branches. She underwent a left modified orbitozygomatic craniotomy for tumor resection. Early identification of the aberrant ACA anatomy was crucial in avoiding vascular injury.
CONCLUSIONS: While this variant is typically encountered during the treatment of vascular pathologies-namely, intracranial aneurysms-its existence should be kept in mind during the treatment of any anterior skull base pathology. Failure to account for the presence of this variant may lead to potential intraoperative complications.
摘要：
背景：大脑前动脉（ACA）的双侧视神经下起源是一种罕见的解剖学变异，可在前颅底手术中遇到。ACA起源于颈内动脉（ICA），位于眼动脉水平和内侧，在同侧视神经下方行进。在这里，作者讨论了解剖变体的不同配置，其患病率,以及导致这种异常的可变配置的假设。
方法：一名67岁的妇女在一周的时间内表现为头晕恶化，并被发现患有视神经的大的左蝶骨脑膜瘤，海绵状,和鞍上延伸。肿瘤合并了左侧上滑膜ICA及其分支。她接受了左侧改良的眶骨开颅手术以切除肿瘤。早期识别异常的ACA解剖结构对于避免血管损伤至关重要。
结论：虽然在血管病变的治疗过程中通常会遇到这种变体-即，颅内动脉瘤-在治疗任何前颅底病变时应牢记其存在。未能解释这种变异的存在可能导致潜在的术中并发症。
方法：一名67岁的妇女在一周的时间内表现为头晕恶化，并被发现患有视神经的大的左蝶骨脑膜瘤，海绵状,和鞍上延伸。肿瘤合并了左侧上滑膜ICA及其分支。她接受了左侧改良的眶骨开颅手术以切除肿瘤。早期识别异常的ACA解剖结构对于避免血管损伤至关重要。
结论：虽然在血管病变的治疗过程中通常会遇到这种变体-即，颅内动脉瘤-在治疗任何前颅底病变时应牢记其存在。未能解释这种变异的存在可能导致潜在的术中并发症。
