Nozaki K, Taki W, Kawakami O, Hashimoto N
Department of Neurosurgery, Kyoto University School of Medicine, Japan.
Acta Neurochir (Wien). 1998;140(4):397-401; discussion 401-2. doi: 10.1007/s007010050114.
Persistent primitive olfactory artery is a rare vascular anomaly but has a clinical importance because of its high association with cerebral aneurysm. We describe a patient with bilateral persistent primitive olfactory arteries associated with an unruptured saccular aneurysm on the left persistent primitive olfactory artery. Seven reported cases with this anomalous artery including ours are reviewed and classified into two variants. This anomalous artery arises from the terminal portion of the internal carotid artery and courses anteromedially along the ipsilateral olfactory tract and makes a hair-pin curve posterior to the olfactory bulb, becoming the distal anterior cerebral artery (variant 1) or the ethmoidal artery (variant 2). Out of 7 reported cases, 4 cases are associated with saccular aneurysms. The aneurysm in variant 1 is located on the hair-pin curve at which an apparent arterial branch is sometimes absent. Two patients suffer from anosmia. Persistent primitive olfactory artery should be kept in mind because of its high association with intracranial saccular aneurysms and unique clinical presentation.
永存原始嗅动脉是一种罕见的血管异常，但因其与脑动脉瘤高度相关而具有临床重要性。我们描述了一名患有双侧永存原始嗅动脉的患者，其左侧永存原始嗅动脉伴有一个未破裂的囊状动脉瘤。包括我们的病例在内，对7例报道的有这种异常动脉的病例进行了回顾并分为两种类型。这种异常动脉起源于颈内动脉末端，沿同侧嗅束向前内侧走行，在嗅球后方形成一个发夹样弯曲，成为大脑前动脉远端（类型1）或筛动脉（类型2）。在7例报道的病例中，4例与囊状动脉瘤相关。类型1中的动脉瘤位于发夹样弯曲处，此处有时没有明显的动脉分支。两名患者患有嗅觉丧失。由于永存原始嗅动脉与颅内囊状动脉瘤高度相关且临床表现独特，应予以重视。
