Department of Neurosurgery and Neurooncology, Copernicus Memorial Hospital, Lodz, Poland.
Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Warsaw, Poland; Department of Pediatric Neurosurgery, Bogdanowicz Memorial Hospital for Children, Warsaw, Poland.
World Neurosurg. 2021 Dec;156:e85-e92. doi: 10.1016/j.wneu.2021.08.137. Epub 2021 Sep 7.
Fenestrations of cerebral arteries are congenital variants that develop when primitive vessels fuse incompletely. An association between the incidence of aneurysm and a fenestrated artery has been noted in the radiological literature. However, technical limitations of radiological studies may hamper visualization of small fenestrations and aneurysms. We sought to analyze a large, postmortem collection of human brains to assess the association between aneurysm formation and the presence of fenestrations.
This study included 333 formalin-fixed brains. The arachnoid was dissected under a microscope, the cerebral arteries were completely exposed, and fenestrations and aneurysms were identified and measured. For each specimen, age, sex, and all vascular abnormalities and variations were recorded for analysis.
Fenestrations were present in 41% of the specimens, and 37% of these were multiple. Fenestrations were 3.1 ± 2.5 mm long and most commonly occurred in the anterior communicating artery (63%). Aneurysms were present in 8% of the specimens, usually in the anterior communicating artery or the middle cerebral artery. An aneurysm correlated with a fenestration was detected in 2% of all specimens (n = 4) and was not statistically significant (P = 0.18).
Fenestrations of the intracranial arteries are a common anatomical finding. They are present most often in the anterior communicating artery. Most aneurysms were detected in the anterior communicating artery and middle cerebral artery. We conclude that the existence of an aneurysm in a fenestrated artery is an incidental, rather than causal, relationship.
脑动脉的窗孔是原始血管不完全融合时发育形成的先天性变异。影像学文献中已经注意到动脉瘤的发生率与窗孔动脉之间存在关联。然而，影像学研究的技术限制可能会阻碍对小窗孔和动脉瘤的可视化。我们试图分析大量的人体大脑尸检样本，以评估动脉瘤形成与窗孔存在之间的关联。
本研究包括 333 例福尔马林固定的大脑。在显微镜下解剖蛛网膜，完全暴露脑动脉，并识别和测量窗孔和动脉瘤。对于每个标本，记录年龄、性别以及所有血管异常和变异，以便进行分析。
41%的标本存在窗孔，其中 37%为多发性窗孔。窗孔长 3.1±2.5mm，最常见于前交通动脉（63%）。8%的标本存在动脉瘤，通常在前交通动脉或大脑中动脉。在所有标本中（n=4），检测到 2%的标本存在与窗孔相关的动脉瘤，但无统计学意义（P=0.18）。
颅内动脉的窗孔是一种常见的解剖学发现。它们最常发生在前交通动脉。大多数动脉瘤发生在前交通动脉和大脑中动脉。我们得出结论，动脉瘤存在于窗孔动脉中是一种偶然的、而非因果关系。
