Azygous Anterior Cerebral Artery Stenosis: An Unusual Cause of Bilateral Frontal Lobe Cerebral Infarctions

Muhammad M Javaid; Shruti G Iyer; Rama D Penumarty; Asif Hussain

doi:10.70302/jpsim.v3i1.2214

Case Report

Azygous Anterior Cerebral Artery Stenosis: An Unusual Cause of Bilateral Frontal Lobe Cerebral Infarctions

Muhammad M Javaid¹

Department of Medicine, South West Healthcare, Warrnambool

Shruti G Iyer¹

Department of Medicine, South West Healthcare, Warrnambool

Rama D Penumarty²

Monash University Victoria, Australia

Asif Hussain²

Monash University Victoria, Australia

✉ Correspondence: Muhammad M Javaid Email: mmjavaid@doctors.org.uk

DOI https://doi.org/10.70302/jpsim.v3i1.2214

Volume: 3, Issue 1 Pages: 66–68 Published: 15 Mar 2022

Received: 14 Dec 2021 Accepted: 02 Jan 2022 Published Online: 15 Mar 2022

Abstract

An azygous anterior cerebral artery is a rare anatomical variant of the Circle of Willis. It is characterised by the absence of the anterior communicating artery and the union of proximal segments to form a single vessel supplying both cerebral hemispheres. Occlusion or stenosis of the single vessel and lack of collateral circulation can lead to bilateral frontal cerebral infarctions, an otherwise relatively uncommon presentation. Knowledge of such an anatomical variant is vital for adequately investigating and managing patients presenting with bilateral anterior cerebral artery territory strokes.

How to Cite This Article

Javaid MM, Iyer SG, Penumarty RD, Hussain A. Azygous Anterior Cerebral Artery Stenosis: An Unusual Cause of Bilateral Frontal Lobe Cerebral Infarctions. J Pak Soc Intern Med. 2022;3(1):66–68. doi:10.70302/jpsim.v3i1.2214

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Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

References

Makowicz G, Poniatowska R, Lusawa M. Variants of cerebral arteries-anterior circulation. Pol J Radiol. 2013;78(3): 42-7.
de Sousa CS, de Miranda CL, Avelino MC, Bastos BB, Moreira de Sousa RS, de Miranda CV. Thrombosis of the Azygos Anterior Cerebral Artery. Case Rep Radiol. 2017;doi: 10.1155/2017/5409430 doi:10.1155/2017/5409430
Krabbe-Hartkamp MJ, van der Grond J, de Leeuw FE, de Groot JC, Algra A, Hillen B, Breteler MM, Mali WP. Circle of Willis: morphologic variation on three-dimensional time-of-flight MR angiograms. Radiol. 1998; 207(1):103-11.
Harrigan MR, Deveikis JP. Handbook of Cerebrovascular Disease and Neurointerventional Technique. Humana Press; 2013.
Toyoda K. Anterior cerebral artery and Heubner's artery territory infarction. Front Neurol Neurosci. 2012;30(2):120-2.
Kubis N, Guichard JP, Woimant F. Isolated anterior cerebral artery infarcts: A series of 16 patients. Cerebrovasc Dis. 1999;9(3):185-7.
Menezes BF, Cheserem B, Kandasamy J, O'BrienD. Acute bilateral anterior circulation stroke due to anomalous cerebral vasculature: a case report. J Med Case Repor. 2008;2(1):188
Kunal Kumar, Daniel Strbian, Sophia Sundararajan. Acute cerebral infarction presenting with weakness in both legs and one arm. Stroke. 2015;46(6): e134-6.

Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

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[1] Makowicz G, Poniatowska R, Lusawa M. Variants of cerebral arteries-anterior circulation. Pol J Radiol. 2013;78(3): 42-7.

[2] de Sousa CS, de Miranda CL, Avelino MC, Bastos BB, Moreira de Sousa RS, de Miranda CV. Thrombosis of the Azygos Anterior Cerebral Artery. Case Rep Radiol. 2017;doi: 10.1155/2017/5409430 doi:10.1155/2017/5409430

[3] Krabbe-Hartkamp MJ, van der Grond J, de Leeuw FE, de Groot JC, Algra A, Hillen B, Breteler MM, Mali WP. Circle of Willis: morphologic variation on three-dimensional time-of-flight MR angiograms. Radiol. 1998; 207(1):103-11.

[4] Harrigan MR, Deveikis JP. Handbook of Cerebrovascular Disease and Neurointerventional Technique. Humana Press; 2013.

[5] Toyoda K. Anterior cerebral artery and Heubner's artery territory infarction. Front Neurol Neurosci. 2012;30(2):120-2.

[6] Kubis N, Guichard JP, Woimant F. Isolated anterior cerebral artery infarcts: A series of 16 patients. Cerebrovasc Dis. 1999;9(3):185-7.

[7] Menezes BF, Cheserem B, Kandasamy J, O'BrienD. Acute bilateral anterior circulation stroke due to anomalous cerebral vasculature: a case report. J Med Case Repor. 2008;2(1):188

[8] Kunal Kumar, Daniel Strbian, Sophia Sundararajan. Acute cerebral infarction presenting with weakness in both legs and one arm. Stroke. 2015;46(6): e134-6.