Anat Cell Biol.  2019 Mar;52(1):43-47. 10.5115/acb.2019.52.1.43.

Magnetic resonance angiography of hypoplastic A1 segment of anterior cerebral artery at 3.0-Tesla in Andhra Pradesh population of India

• Pentyala S
• Sankar KD
• Bhanu PS
• Kumar NS

• KMID: 2442328
• DOI: http://doi.org/10.5115/acb.2019.52.1.43

Abstract

Pre-communicating or A1 segment of anterior cerebral artery (A1ACA) hypoplasia can negotiate the anterior cerebral circulation. Not many studies have been examined the association of hypoplastic A1ACA and cerebral ischemic stroke (CIS). In this study the authors' want to accomplish the relationship between hypoplastic A1ACA and outcomes among the patients with CIS in Andhra Pradesh population of India. Retrospective review of prospectively identified 201 adult patients with CIS from 2015 to 2017 was achieved. Patients underwent 3.0T intracranial magnetic resonance angiography were compared with clinical and radiological aspects between male and female cases of A1ACA hypoplasia with associated variations in the circle of Willis. The obtained data was statistically analysed using SPSS software version 16.0 for Windows and P-value <0.05 was considered as significant. Chi-square test was applied to find out the association between the sex and incidence of hypoplastic A1ACA. Sixty-four of 201 patients with A1ACA hypoplasia with no aplastic cases were recorded. It was found to be more in males than females and common on right than left side. Frequent neurological indications such as headache, dizziness, visual instability, nausea, weakness of extremities and seizure were noted and most cases were associated with CIS. Hypoplastic A1ACA often associated with ischemia of terminal branches of ipsilateral ACA which is compromised by the blood flow via contralateral ACA. In this study, though the CIS is not directly related to hypoplastic A1ACA, any alterations in A1 segment is a considerable risk factor of stroke.

Keyword

Anterior cerebral artery; A1 segment; Hypoplasia; Cerebral stroke; Transient ischemic attack; Stroke; Magnetic resonance angiography

MeSH Terms

Adult
Anterior Cerebral Artery*
Cerebrovascular Circulation
Circle of Willis
Dizziness
Extremities
Female
Headache
Humans
Incidence
India*
Ischemia
Ischemic Attack, Transient
Magnetic Resonance Angiography*
Male
Nausea
Prospective Studies
Retrospective Studies
Risk Factors
Seizures
Stroke

Figure

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  Fig. 1 (A, B) Cerebral magnetic resonance angiogram showing the right and left hypoplasia of A1 segment of anterior cerebral artery (arrow), respectively.

• 

  Fig. 2 (A) Cerebral magnetic resonance angiography (MRA) showing the right hypoplastic A1 segment of anterior cerebral artery (arrow) with fetal-type posterior cerebral circulation for total absence of right P1 segment of posterior cerebral arteries (arrowhead). (B) MRA showing the hypoplastic A1, 2, and 3 segments of anterior cerebral artery (ACA) (arrow) and no blood flow related signal was noted, identified it as complete hypoplasia of ACA.

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