Ćetković Mila, Boljanović Jelena, Bexheti Ema, Vitošević Filip, Bogićević Damljan, Milašinović Sonja, Bexheti Sadi, Ćetković Dejan, Dožić Aleksandra, Milisavljević Milan
Faculty of Medicine, Institute of Histology and Embryology, University of Belgrade, Belgrade, Serbia.
Laboratory for Vascular Morphology, Faculty of Medicine, Institute of Anatomy, University of Belgrade, Belgrade, Serbia.
Front Neuroanat. 2025 Mar 26;19:1523305. doi: 10.3389/fnana.2025.1523305. eCollection 2025.
Fenestration of the intracranial artery is an anatomical remnant from the embryonic development of the vascular system. A cerebral aneurysm is a focal pathological dilation of the arterial wall. The occurrence of an aneurysm at the site of fenestration is rare in cerebral circulation but may have potential clinical implications. This study aimed to identify the frequencies of fenestrations and aneurysms, their locations, and their relationships. The vasculature of 35 adult brains was used for micromorphological dissection and analysis under a stereoscopic microscope, following an arterial injection with a mixture of formaldehyde, melted gelatin, and the solution of India ink. Additionally, we analyzed another group of vascular casts obtained from 15 brains injected with methyl methacrylate (MMA). A fenestration of the M1 segment of the middle cerebral artery (MCA) was sectioned for histological analysis. We also examined computed tomography (CT) angiograms of 1,230 patients, analyzed the data, and compared the findings with anatomical observations. In our group of 50 anatomical specimens, fenestrations were found in 12 brains (24%), affecting different cerebral arteries, with three cases showing double fenestrations on the same vessel. Aneurysms were observed in six brains (12%), always one per brain, with one case (2.00%) involving an aneurysm associated with the wall of a fenestration. Analysis of CT angiograms from 1,230 patients showed 26 arterial fenestrations (2.11%) in 26 patients, 28 aneurysms (2.28%), and one case (0.08%) where an aneurysm arose from a fenestration. The presence of an aneurysm on a fenestrated cerebral artery is a rare phenomenon, occurring far less frequently than isolated fenestrations or aneurysm formation.
颅内动脉开窗是血管系统胚胎发育过程中遗留的一种解剖结构。脑动脉瘤是动脉壁的局限性病理性扩张。在脑循环中，开窗部位出现动脉瘤的情况较为罕见，但可能具有潜在的临床意义。本研究旨在确定开窗和动脉瘤的发生率、位置及其相互关系。对35例成人大脑的血管系统进行微形态学解剖分析，具体操作是在立体显微镜下，先经动脉注入甲醛、明胶和印度墨水混合液，之后进行分析。此外，我们还分析了另一组由15例注入甲基丙烯酸甲酯（MMA）的大脑所获得的血管铸型。对大脑中动脉（MCA）M1段的一个开窗进行了组织学分析。我们还检查了1230例患者的计算机断层扫描（CT）血管造影，分析数据，并将结果与解剖学观察结果进行比较。在我们的50例解剖标本组中，12例大脑（24%）发现有开窗，累及不同的脑动脉，其中3例在同一血管上出现双开窗。6例大脑（12%）观察到动脉瘤，每例大脑均为1个动脉瘤，其中1例（2.00%）动脉瘤与开窗壁相关。对1230例患者的CT血管造影分析显示，26例患者（2.11%）有26处动脉开窗，28例（2.28%）有动脉瘤，1例（0.08%）动脉瘤起源于开窗。有开窗的脑动脉上出现动脉瘤是一种罕见现象，其发生频率远低于孤立的开窗或动脉瘤形成。
