Anatomical Variants of Cerebrovascular Systems
Summary
Anatomical variants of the cerebrovascular system comprise a spectrum of congenital deviations from the typical vascular architecture supplying the brain. These include persistent embryonic anastomoses such as the primitive trigeminal, hypoglossal and proatlantal arteries, variations in the circle of Willis (for example, hypoplastic or duplicated segments) and agenesis of key junctions like the vertebrobasilar connection. Such anomalies arise during early embryonic development when transient vessels may fail to regress or when normal vessel fusion is incomplete. Although often clinically silent, these variants can alter haemodynamic patterns, predispose to aneurysm formation, complicate diagnostic angiography and influence the risk or presentation of stroke. Moreover, recognition of these patterns is essential for planning safe neurosurgical and endovascular interventions, as unexpected vessel courses may serve as critical collateral pathways or represent sites of pathological change.
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Anatomical Variants of Cerebrovascular Systems publication trend
The graph below shows the total number of articles in anatomical variants of cerebrovascular systems across all publications each year (not limited to Nature Index journals).
Technical terms
Persistent primitive trigeminal artery: A fetal carotid–basilar anastomosis that normally regresses but, when persistent, connects the internal carotid artery to the basilar trunk.
Persistent primitive hypoglossal artery: An embryonic vessel linking the cervical carotid system to the basilar artery, whose persistence alters posterior circulation flow.
Vertebrobasilar junction agenesis: Congenital absence of the normal fusion between the vertebral arteries and the basilar artery, often compensated by collateral vessels.
Circle of Willis: The polygonal arterial ring at the base of the brain ensuring collateral circulation between anterior and posterior territories.
Endovascular treatment: Minimally invasive catheter-based procedures to diagnose or treat vascular pathology, including balloon angioplasty, stenting and coil embolisation.
References
- Clinical Importance of the Persistent Primitive Trigeminal Artery in Vascular Lesions and Its Role in Endovascular Treatment. Frontiers in Neurology (2022).
- Concurrence of multiple aneurysms, extreme coiling of the extracranial internal carotid artery and ipsilateral persistent primitive hypoglossal artery: A case report and literature review. Frontiers in Neurology (2022).
- Bilateral Segmental Agenesis of the Vertebrobasilar Junction: Developmental and Angiographic Anatomy. American Journal of Neuroradiology (2007).
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