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E1892. Variant Arterial Anatomy of the Head and Neck: What the Radiologist Needs to Know
Authors
  1. Yonatan Rotman; University of Rochester
  2. Jarett Thelen; University of Rochester
Background
Arterial vasculature of the head and neck shows marked heterogeneity in the general population. Anatomic variants can have important clinical consequences when vessels are occluded, and variations may affect treatment decisions and endovascular interventions. Therefore, it is important for the neuroradiologist to understand the common variations in cerebral vasculature and convey those variants to practicing providers in order to optimize treatment outcomes. The goal of this exhibit is to review and demonstrate important anatomic variants of the anterior and posterior circulations.

Educational Goals / Teaching Points
The first goal of this presentation will be to review "normal” circulatory anatomy. Second goal will be to identify important anatomic variations and characterize them in multiple modalities (CT Angiography, MR Angiography, Digital Subtraction Angiography). The final goal will be to recognize when anatomic variations may lead to adaptations in the technical approach of endovascular procedures and when they could affect clinical outcomes of infarctions.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This presentation will discuss important common and uncommon anatomic variants of the anterior circulation, including hypoplastic internal carotid artery, accessory medial cerebral artery, triplicate anterior cerebellar artery, and others. These anatomic variations will be depicted in different modalities including CT angiography, MR angiography and digital subtraction imaging (DSA). The presentation will then transition to discussing common and uncommon anatomic variants of the posterior circulation including fetal origin of posterior cerebral artery, persistent trigeminal artery, persistent hypoglossal artery, basal artery fenestration and others. These anatomic variations will again be depicted in different modalities including CT angiography, MR angiography and digital subtraction imaging (DSA).

Conclusion
Variant arterial vasculature of the head and neck is important to identify. These variants will often affect management and clinical outcomes in patients with acute infarction or those undergoing surgery or endovascular procedures. We have identified some important anatomic variants so that practicing radiologist will be able to detect them and communicate the findings to the clinical providers in order to optimize treatment outcomes.