1. 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

2. 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

3. 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

4. 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

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

6. 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

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

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

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

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

11. 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

12. 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

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

14. 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

15. 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

16. 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

17. 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

18. 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