Dural branch of the A.C.A Francesco Signorelli, Felix Scholtes, Nancy McLaughlin, Michel W. Bojanowski Centre Hospitalier de l'Université de Montréal, Canada Università degli Studi "Magna Græcia" di Catanzaro, Italy Centre Hospitalier Universitaire, Université de Liège, Belgium F. Signorelli, F. Scholtes, N. McLaughlin, M.W. Bojanowski – Dural Branch from ACA

Dural arteries 3 systems (external carotid, internal carotid, vertebrobasilar) Anterior fossa Anterior ethmoidal (IC: opthalmic) Posterior ethmoidal (IC: ophtalmic) Superficial recurrent branch (IC: opthalmic; anastomosis with middle meningeal) Olfactory branches from ACA (IC) Middle meningeal, except if ophthalmic origin (EC) Planum F. Signorelli, F. Scholtes, N. McLaughlin, M.W. Bojanowski – Dural Branch from ACA

Case presentation 62 yo female Several months' history of « environmental dependency syndrome ». Missing initiative Described as « slow » and « confuse » Lesion + Edema... F. Signorelli, F. Scholtes, N. McLaughlin, M.W. Bojanowski – Dural Branch from ACA

Case presentation 62 yo female Several months' history of « environmental dependency syndrome ». Missing initiative Described as « slow » and « confuse » Lesion + Edema... F. Signorelli, F. Scholtes, N. McLaughlin, M.W. Bojanowski – Dural Branch from ACA

Case presentation .. .planum sphenoidale meningioma F. Signorelli, F. Scholtes, N. McLaughlin, M.W. Bojanowski – Dural Branch from ACA

Surgical finding Explain - pterional approach - temporal lobe below, frontal lobe above left - anterior clinoid - optic nerve - carotid entrance not visible - planum sphnenoidale - anterior F. Signorelli, F. Scholtes, N. McLaughlin, M.W. Bojanowski – Dural Branch from ACA

Surgical finding .. .planum sphenoidale meningioma F. Signorelli, F. Scholtes, N. McLaughlin, M.W. Bojanowski – Dural Branch from ACA

Surgical finding .. .planum sphenoidale meningioma F. Signorelli, F. Scholtes, N. McLaughlin, M.W. Bojanowski – Dural Branch from ACA

Post-op MRI F. Signorelli, F. Scholtes, N. McLaughlin, M.W. Bojanowski – Dural Branch from ACA

Post-op angio-CT F. Signorelli, F. Scholtes, N. McLaughlin, M.W. Bojanowski – Dural Branch from ACA

Anatomical significance Yasargil: dural branch from pre-bifurcation carotid to anterior clinoid process 2 cases: origin at anterior cerebral artery (to limbus) Lasjaunias (cited also by Martins, Rhoton): dural olfactory branches of ACA anastomose with ethmoidal (ant/post) Olfactory branches: from long A2 branches (Ciolkowski) cortical (ant./post. Orbito-frontal) subcortical (Heubner) Yasargil: usually 3-5 mm before bifurcation. Once 1 vessel from ACA. Once bilateral vessels from ACA to limbus sphenoidale Olfactory branches go to more anterior parts of orbital roof (ala minor and frontal bone). . Yasargil MG (1984) Operative anatomy. Yasargil MG Micro- neurosurgery vol I. Georg Thieme Verlag Stuttgart, In, pp 70–71 Lasjaunias P, Berenstein A (1987) Surgical neuroangiography, vol 1. Springer-Verlag, New York Martins C, Yasuda A, Campero A, Ulm AJ, Tanriover N, Rhoton A Jr (2005) Microsurgical anatomy of the dural arteries. Neurosurgery 56(2 Suppl):211–251 Ciołkowski M, Michalik R, Ciszek B (2004) Arteries to the proximal part of the olfactory tract. Folia Morphol (Warsz) 63:455– 458 F. Signorelli, F. Scholtes, N. McLaughlin, M.W. Bojanowski – Dural Branch from ACA

Anatomical significance Yasargil: usually 3-5 mm before bifurcation. Once 1 vessel from ACA. Once bilateral vessels from ACA to limbus sphenoidale Olfactory branches go to more anterior parts of orbital roof (ala minor and frontal bone). . Martins C, Yasuda A, Campero A, Ulm AJ, Tanriover N, Rhoton A Jr (2005) Microsurgical anatomy of the dural arteries. Neurosurgery 56(2 Suppl):211–251 F. Signorelli, F. Scholtes, N. McLaughlin, M.W. Bojanowski – Dural Branch from ACA

Embryology: the olfactory artery F. Signorelli, F. Scholtes, N. McLaughlin, M.W. Bojanowski – Dural Branch from ACA

Embryology: the olfactory artery 4mm Padget DH (1948) The development of the cranial arteries in the human embryo. Contrib Embryol 32:205–262 F. Signorelli, F. Scholtes, N. McLaughlin, M.W. Bojanowski – Dural Branch from ACA

Embryology: the olfactory artery Cranial division of internal carotid artery = primitive olfactory artery 4mm Caudal division is the posterior communicating artery. Padget DH (1948) The development of the cranial arteries in the human embryo. Contrib Embryol 32:205–262 F. Signorelli, F. Scholtes, N. McLaughlin, M.W. Bojanowski – Dural Branch from ACA

Embryology: the olfactory artery 9mm Cranial division of internal carotid artery = primitive olfactory artery Primitive olfactory artery: directed towards nasal fossa Padget DH (1948) The development of the cranial arteries in the human embryo. Contrib Embryol 32:205–262 F. Signorelli, F. Scholtes, N. McLaughlin, M.W. Bojanowski – Dural Branch from ACA

Embryology 18mm Cranial division of internal carotid artery = primitive olfactory artery Primitive olfactory artery: directed towards nasal fossa Main division (lateral): CN-I normally regresses Medial Branch: anterior cerebral artery Padget DH (1948) The development of the cranial arteries in the human embryo. Contrib Embryol 32:205–262 F. Signorelli, F. Scholtes, N. McLaughlin, M.W. Bojanowski – Dural Branch from ACA

Surgical importance Avulsion may lead to bleeding from ACA Aneurysm surgery (papaverine) Pre-op diagnosis interesting, especially when vessel of significant caliber F. Signorelli, F. Scholtes, N. McLaughlin, M.W. Bojanowski – Dural Branch from ACA