Abstract
Introduction
Fenestrations of cerebral arteries are most common in the vertebrobasilar (VB) system, and magnetic resonance (MR) angiographic studies of these variations are sparse.
Methods
We retrospectively reviewed MR angiographic images of 3,327 patients; images were obtained using two 1.5-T imagers and picked up fenestrations of the intracranial vertebral artery (VA), VB junction, and basilar artery (BA) for evaluation.
Results
In 92 patients, we found 93 fenestrations (2.80%), which included 18 of the intracranial VA (0.54% prevalence), 6 of the VB junction (0.18%), and 69 of the BA (2.07%). Most VA fenestrations were large, and the posterior inferior cerebellar artery arose from the fenestrated segment in 10 patients (56%). Fenestrations of the VB junction were small and triangular. Sixty-five (94%) of the 69 BA fenestrations were located at the proximal segment and had small slit-like configurations. The anterior inferior cerebellar artery arose from the fenestrated segment in 27 patients (37%). We found 18 cerebral aneurysms in 16 (17%) of the 92 patients with fenestration but detected only one aneurysm at the fenestration.
Conclusion
The overall prevalence of fenestrations of the intracranial VB system was 2.77%. We found associated cerebral aneurysms relatively frequently but rarely at the fenestration.
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00234-011-0903-x/MediaObjects/234_2011_903_Fig1_HTML.gif)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00234-011-0903-x/MediaObjects/234_2011_903_Fig2_HTML.gif)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00234-011-0903-x/MediaObjects/234_2011_903_Fig3_HTML.gif)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00234-011-0903-x/MediaObjects/234_2011_903_Fig4_HTML.gif)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00234-011-0903-x/MediaObjects/234_2011_903_Fig5_HTML.gif)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00234-011-0903-x/MediaObjects/234_2011_903_Fig6_HTML.gif)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00234-011-0903-x/MediaObjects/234_2011_903_Fig7_HTML.gif)
Similar content being viewed by others
References
Uchino A, Kato A, Takase Y et al (2001) Basilar artery fenestrations detected by MR angiography. Radiat Med 19:71–74
Tanaka M, Kikuchi Y, Ouchi T (2006) Neuroradiological analysis of 23 cases of basilar artery fenestration based on 2280 cases of MR angiographies. Interv Neuroradiol 12(Suppl 1):39–44
Uchino A, Saito N, Watadani T, et al. (2011) Vertebral artery variations at the C1-2 level diagnosed by magnetic resonance angiography. Neuroradiology. doi:10.1007/s00234-011-0849-z
van Rooij SB, van Rooij WJ, Sluzewski M et al (2009) Fenestrations of intracranial arteries detected with 3D rotational angiography. AJNR Am J Neuroradiol 30:1347–1350
Kowada M, Yamaguchi K, Takahashi H (1972) Fenestration of the vertebral artery with a review of 23 cases in Japan. Radiology 103:343–346
Lasjaunias P, Braun JP, Hasso AN (1980) True and false fenestration of the vertebral artery. J Neuroradiol 7:157–166 [Article in English, French]
Uchino A, Sawada A, Takase Y et al (2002) Extreme fenestration of the right vertebral artery: magnetic resonance angiographic demonstration. Eur Radiol 12:S32–S34
Lesley WS, Rajab MH, Case RS (2007) Double origin of the posterior inferior cerebellar artery: association with intracranial aneurysm on catheter angiography. AJR Am J Roentgenol 189:893–897
Plumb AA, Herwadkar A, Laitt R (2009) Double origin of the posterior inferior cerebellar artery with findings on conventional and CT angiography. Surg Radiol Anat 31:393–395
Takahashi M, Tamakawa Y, Kishikawa T et al (1973) Fenestration of the basilar artery. Report of three cases and review of the literature. Radiology 109:79–82
Wollschlaeger G, Wollschlaeger PB, Lucas FV et al (1967) Experience and result with postmortem cerebral angiography performed as routine procedure of the autopsy. Am J Roentgenol Radium Ther Nucl Med 101:68–87
Padget DH (1948) The development of cranial arteries in the human embryo. Contrib Embryol 32:207–261
Goldstein JH, Woodcock R, Do HM et al (1999) Complete duplication or extreme fenestration of the basilar artery. AJNR Am J Neuroradiol 20:149–150
Uchino A, Sawada A, Takase Y et al (2002) Extreme fenestration of the basilar artery associated with cleft palate, nasopharyngeal mature teratoma, and hypophyseal duplication. Eur Radiol 12:2087–2090
Campos J, Fox AJ, Viñuela F et al (1987) Saccular aneurysms in basilar artery fenestration. AJNR Am J Neuroradiol 8:233–236
Tasker AD, Byrne JV (1997) Basilar artery fenestration in association with aneurysms of the posterior cerebral circulation. Neuroradiology 39:185–189
Sanders WP, Sorek PA, Mehta BA (1993) Fenestration of intracranial arteries with special attention to associated aneurysms and other anomalies. AJNR Am J Neuroradiol 14:675–680
Uchino A, Kato A, Abe M et al (2001) Association of cerebral arteriovenous malformation with cerebral arterial fenestration. Eur Radiol 11:493–496
Scherer A, Siebler M, Aulich A (2002) Virtual arterial endoscopy as a diagnostic aid in a patient with basilar artery fenestration and thromboembolic pontine infarct. AJNR Am J Neuroradiol 23:1237–1239
Kloska SP, Schlegel PM, Sträter R et al (2006) Causality of pediatric brainstem infarction and basilar artery fenestration? Pediatr Neurol 35:436–438
Acknowledgment
We thank Rosalyn Uhrig, M.A., for editorial assistance in the preparation of this manuscript.
Conflict of interest
We declare that we have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Uchino, A., Saito, N., Okada, Y. et al. Fenestrations of the intracranial vertebrobasilar system diagnosed by MR angiography. Neuroradiology 54, 445–450 (2012). https://doi.org/10.1007/s00234-011-0903-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00234-011-0903-x