Relationship between cerebral aneurysms and variations in cerebral basal arterial network: a morphometric cross-sectional study in Computed Tomography Angiograms from a neurointerventional unit

• Published in: BMJ open Vol. 11; no. 9; p. e051028
• Main Authors: Burlakoti, Arjun, Kumaratilake, Jaliya, Taylor, Jamie, Henneberg, Maciej
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 16.09.2021; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: Adult; anatomy; Aneurysms; Carotid arteries; Carotid Artery, Internal - diagnostic imaging; Cerebral Angiography; Cross-Sectional Studies; Female; Humans; Intracranial Aneurysm - diagnostic imaging; Male; Medical imaging; Neurology; neuroradiology; neurosurgery; Retrospective Studies; Software; Statistical analysis; Stroke; Tomography, X-Ray Computed; vascular surgery; Veins & arteries; neuroradiology; neurosurgery; anatomy; stroke; vascular surgery
• DOI: 10.1136/bmjopen-2021-051028
• ISSN: 2044-6055

ObjectiveSegments of cerebral basal arterial network (CBAN) dampen the peak pressure in blood flowing through these arteries, thus minimising the chances of development of cerebral aneurysms. The objective of this research was to find the relationship of occurrence of intracranial aneurysms to variations of the components of the CBAN.Design and settingThis is an observational, quantitative and retrospective research, which used cerebral CT angiography (CCTA) images.ParticipantsCerebral CTA of 145 adult patients of both sexes were studied.Main outcome measuresDiameters of segments of CBAN were measured in CCTA images and the relative size of each vessel was calculated to standardise for differences in overall arterial sizes among patients. Relationships among sizes of CBAN components were analysed. Presence of aneurysms in different parts of the CBAN was recorded.ResultsForty-six aneurysms in right internal carotid artery (ICA) and middle cerebral artery (MCA) and 32 aneurysms in left ICA and MCA segments were noted in 42 and 30 patients, respectively. Aneurysms in anterior communicating artery complex and vertebral-basilar arterial segments were seen in 27 and 8 patients, respectively, while they were not detected in parts of posterior cerebral artery (PCA). The significant (p<0.001) inverse relationships between sizes of posterior communicating artery and the first segment of PCA on both sides indicated that blood inputs to the second part of PCA were similar. Difference in means of the index of arterial size variation for people with aneurysms (mean 0.96, SD 0.23) and without aneurysms (mean 0.86, SD 0.22) was significant (p=0.015).ConclusionVariation in segments of CBAN was quantified. The peak pressure dampening mechanism in such arterial segments reduces the chances of development of aneurysms.