E2169. Normal Variants of the Cerebral Circulation and Associated Pathology: A Review Using CTA, MRA, and DSA
Authors
Fabianna Himet Coll;
San Juan Bautista School of Medicine
Sylvia Eliza Perez;
San Juan City Hospital
Mario Polo Asenjo;
Hospital Menonita de Caguas ; San Juan Bautista School of Medicine
Background
Vascular variants of the cerebral circulation are usually incidental findings in angiographic studies ordered for other clinical reasons. Recognizing normal vascular variants is crucial to avoid unnecessary imaging studies or potentially misdiagnosing them as pathology. Some vascular variants are of little clinical significance, yet others are associated with an increased risk of aneurysm formation. For this reason, proper reporting of these findings by radiologists can guide management by other specialists. Knowledge of the variant anatomy is also crucial in preoperative planning, especially clipping and endovascular treatment of aneurysms.
Educational Goals / Teaching Points
The target audience of this educational exhibit is medical students, radiology residents, general radiologists, and neuroradiologists. The primary goal of the exhibit is to review common and rare vascular variants of the cerebral circulation. It will also examine vascular pathology associated with vascular variants, including aneurysms and stenosis. After reviewing this presentation, the reader should be able to recognize normal vascular variants, properly identify them in the report, and be cognizant of potential associated pathology.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
In this educational exhibit, we will discuss both common and rare variants of the cerebral circulation using computed tomographic angiography (CTA), magnetic resonance angiography (MRA), and digital subtraction angiography (DSA). These may be broadly categorized into duplicated and accessory vessels, fenestrations, and persistent carotid-basilar anastomosis.
Conclusion
After viewing this exhibit, the reader will have reviewed common anatomical variants of intracranial circulation and will be familiarized with variations less commonly seen in radiological practice. The significance of recognizing these benign variants is the avoidance of misdiagnoses and unnecessary workups. In addition, identifying associated pathologies is essential to guide patient management and treatment when warranted.
